Follow these guideines for success
First Visit #1:
+ Office Visit New CPT 99203-05
+ Office Visit Established CPT 99213-15
(Complete MINI screen & schedule follow up
appointment to take full M.I.N.I. if positive)
Second Visit #2:
+ Office Visit Established CPT 99204
+ Psychiatric Diagnostic evaluation CPT 90791
+ Psychiatric Diagnostic evaluation w/
Medical Services CPT 90792
(Complete MINI & schedule follow up appointment to review results of MINI complete diagnosis & Treatment plan)
Third Visit #3:
+ Office Visit Established CPT 99204
+ Neuropsychological test review CPT 96118
Let's talk
Strategy...
Identify a Behaviorial Health lead within your office and train them how to approach the patient in
regards to the assessment. Have them inform the patient
that the doctor would like them to fill the M.I.N.I. Screen
out while they wait to see the doctor.
Explain the purpose of the M.I.N.I. is not only to meet the
new ACA guidelines but also help identify hidden
comorbidities that my be impacting current treatments.
Make sure your staff are available to help those patients who have a difficult time seeing or reading
the questions. It is important to make sure that the staff reads the questions from the assessment
exactly as they are written.
Clearly define “what's next and what does it mean?” Explain that the
typical process looks like this:
+ Bio Psychosocial (Family History)
+ Make a diagnosis if it is appropriate
+ Create a custom treatment plan (that may or may
not include medications)
+ Explain what psychotherapy is (if applicable)
+ The need for outcome tracking to make sure both the
drugs and the therapy are working.
+ They will recieve periodic calls to help insure you are sticking to
your medication schedule
Communicate with the doctor about those patients that may need immediate help, or those
patients the may have answered "NO" to all questions despite the doctors or clincians strong belief that the patient may not be telling the truth.
Common Fatal Mistakes
Do not call this a survey. The M.I.N.I. is not and has never been a "survey". It is a diagnostic interview that screens for up to 24 DSM disorderds in over 70 languages. The M.I.N.I. saves lives everyday, not only through the suicide screens but by accurately diagnosing the patient. Bipolar looks very simular to depression to the some PCP's. Thats because the patient doesn't come to you when they are in a manic phase (feeling 10 feet tall and bullet proof!), they come to you when they are feeling down. 17% of patients with bipolar committ suicide each year.
Do not call this a mental health questionnaire. It is unfortunate that as a society we still have such a stigma associated to "Mental Health". Claims data from the National Insititues of Health tell us that 30% of the population walks around each year with a mental health diagnosis, If you approach them asking to take a mental health assesment you will have a difficult time.
Do not refer to the MINI Screen as “optional” in anyway. The Afforadable Care Act (Obama Care) requires an annual depression screen be doene by the PCP, and that screen must meets the standards set forth by the national Centers for Excellence for Depression. The diagnostic screen my be validated and strucutred and "widely" used or cited in clinical research. Most psycians use the Patient Health Questionaire 9 (PHQ), usually becaus it comes free with thier EMR or they don't understand that the PHQ 9 is a checklist to see if you have ever had a Depressive Episode - thats it.
Do not have the patient take the MINI screen on their way out of their appointment. Have them fill out the M.I.N.I. Screen or M.I.N.I. KID screen during the first office visit. If they have a positive score, set up a follow-up appointment to take the full M.I.N.I. or M.I.N.I. KID
Do not allow the patient to take the MINI screen home to bring back later. During the first office visit have one of your staff politly inform the patient that the doctor would like them to fill this out while they wait.