Alzheimer's disease.

Alzheimer's disease is the most prevalent form of dementia. There are significant efforts underway to elucidate the pathogenesis of this disease and to find ways to lessen the impact of the symptoms. This paper summarizes current knowledge regarding the diagnosis and treatment of the disorder.

Psychiatry billing for nursing home services: understanding coding options.

This article reviews information on coding options, documentation, and payment for both initial and follow-up visits in the nursing home setting. Specific information is provided for both the psychiatry as well as the Evaluation & Management (E&M) code series. Payments are compared for comparable services in order to provide the nursing home psychiatrist with an understanding of the options available. Documentation, background information, and proposed note formatting are also provided. Proper use of the E&M series can provide valuable coding options.

Billing for the Evaluation and Treatment of Adult Depression by the Primary Care Clinician.

Depression is a common problem encountered in primary care practice. There are many barriers that the primary care clinician faces in managing patients with depression. Financial reimbursement is one infrequently addressed barrier that influences how care is provided. This article addresses the coding, documentation, and reimbursement issues that pertain to the treatment of depression in the primary care setting. Coding options are reviewed with specific documentation guidelines. Reimbursement and fee schedule issues are also addressed, including clarification of certain limitations on payment by some payers.

Billing for psychiatric evaluations: options for coding and reimbursement.

The complexity of the current practice environment challenges clinicians to master complicated billing and coding regulations. Failure to properly bill and code can result in reduced potential revenue for services providers and, if improperly done, could lead to paybacks or penalties for the clinician. The purpose of this article is to assist psychiatrists in choosing the optimal coding for new evaluations and to understand the documentation requirements. Comparisons are provided between the "psychiatry codes" and the "evaluation and management" series. Details of required history, examination, and medical decision-making are listed in order to provide the tailed knowledge necessary to appropriately utilize some higher paying evaluation and management coding options for psychiatric evaluations.

Tardive dyskinesia in elderly patients: an update.

The use of antipsychotic agents can be limited by side effects, particularly extrapyramidal symptoms (EPS) and tardive dyskinesia (TD). These neurologic movement disorders can occur early in the course of treatment (often as EPS) or as a more latent effect (TD). TD can be debilitating, and several patient-related and treatment-related factors have been associated with an increased risk for its development. Of these, older age has been strongly linked to TD. The advent of novel antipsychotics for the treatment of schizophrenia and severe behavioral disorders permits the use of such agents with reduced risk of EPS and TD. Most clinical trials of the novel antipsychotics have enrolled younger patients, but some data on their efficacy and safety in the elderly are now available. This article reviews the relationship between TD and aging and its treatment in elderly patients.

Management of behavioral complications of dementia.

The behavioral and psychotic complications of dementia are common clinical problems, requiring a review of past psychiatric diagnosis, as well as medical differential diagnosis to uncover potentially treatable causes. Behavioral factors can play an important contributing role and behavioral interventions can sometimes significantly improve or reduce symptoms' emergence. Psychotropic medications when properly selected and monitored can significantly reduce agitated behavioral and psychotic symptoms associated with dementia and may have very positive impact on a patient's quality of life, a family's ability to manage patients in the community, and a resident's nursing home management.

Tardive dyskinesia in elderly patients: an update.

The use of antipsychotic agents can be limited by side effects, particularly extrapyramidal symptoms (EPS) and tardive dyskinesia (TD). These neurologic movement disorders can occur early in the course of treatment (often as EPS) or as a more latent effect (TD). TD can be debilitating, and several patient-related and treatment-related factors have been associated with an increased risk for its development. Of these, older age has been strongly linked to TD. The advent of novel antipsychotics for the treatment of schizophrenia and severe behavioral disorders permits the use of such agents with reduced risk of EPS and TD. Most clinical trials of the novel antipsychotics have enrolled younger patients, but some data on their efficacy and safety in the elderly are now available. This article reviews the relationship between TD and aging and its treatment in elderly patients.