Connecticut Psychiatrist

The Newsletter of the Connecticut Psychiatric Society

To contribute an article or guest essay, please send your 400-600 word piece to the attention of Steven Madonick, MD, Editor to cps@ssmgt.com.

In this issue:

President's Column
Psychiatrists Do So Much More Than "Medication Management"
Legislative Session Preview
Telehealth Must be Continued in Psychiatry
Can you Understand the Complexity of Medical Coding in Psychiatry?
Obituary: Dr. Kunjathan Thankappan
News from the APA

President's Column

John Santopietro, MD, DFAPA

‘Tis the season…for surveys and retreats.

As I look out the window at one of the first snows of the season, I feel like I can see (knock on wood) the light at the end of our three-year pandemic tunnel of trauma. We’re emerging from our caves, gathering again in groups, looking at each other face to face – not screen to screen and (increasingly) not mask to mask. It’s like we’re asking:

“Is everyone still here? Is everyone ok?”

And, once that’s established:

“Remind me what we’re doing again? What’s it all about?”...

Psychiatrists Do So Much More Than

"Medication Management"

Steven Madonick, MD

There is more to a psychiatrist doing “medication management” in an adult outpatient program than many people might think. Over the past 8 hours, I saw 18 patients. They had 62 psychiatric, substance use, and medical diagnoses. They were each prescribed medication, in a scientific and rational manner, although with many potential side effects and many interactions with other medications. There are many patients who need far more than medication management and they remain my responsibility...

Legislative Session Preview

Carrie Rand-Anastasiades

The 2023 session is set to begin January 4th. The Democrats won convincingly in November and have elected what might be the most progressive group of legislators CT has ever seen. Their focus will be healthcare, energy, and transportation policy which are emerging as preeminent issues the General Assembly will tackle. The economy and cost of goods will also take center stage.

Over the past two election cycles, which included the COVID years, approximately eighty new legislators have been elected. We expect the Capitol to be back to business as usual and reintroducing CPS will be our top priority...

Telehealth Must be Continued in Psychiatry

Sheila Cooperman, MD

There is no doubt that the pandemic has facilitated widespread use of telehealth services including traditional video services and, for the first time, audio-only or telephonic, services in psychiatry. Prior to the pandemic, CPS explored the support of telehealth services by third-party payers in Connecticut. Melissa Welby, past CPS President, discussed the challenges of telehealth and the various barriers. Many of her private-pay patients favored them over in-person sessions to save time commuting or to save time for child or elder care...

Can You Understand the Complexity of

Medical Coding in Psychiatry?

Christopher Hammel, MD, MPH

The following represent some things I have learned over the past few years in full-time private practice. Please note that I am not a medical coder; the following represent only my personal experiences and opinions. The ultimate authority is the AMA’s CPT Book, which can be purchased online for about $60.

Intakes: As of January 1, 2021, visits can be billed according to time rather than complexity, allowing simplified documentation. Thus, an intake of 60-74 minutes can be billed as the highest-level code, 99205, regardless of complexity. You can also add instances of 99417 (see below) for visits >=75 minutes, but some insurers are not reimbursing appropriately for that code at this time. Thus, for a 2-hour intake, reimbursement may improve significantly if you divide it into two 1-hour sessions and bill them as 99205 and 99215+99417...

Obituary: Dr. Kunjathan Thankappan

Velandy Manohar, MD

Dr. Kunjathan Thankappan passed away on Thursday, December 1^st, 2022, surrounded by his loving family in Newark, DE. He was 84 years old. He is survived by his wife Chandrika, and three sons, Sunil, Sudhir, and Sujith, and their families. He was the son of the late Velumbi and Kunjathan Thankappan, and was born in Kerala, India on October 26, 1938. Dr. Thankappan was a graduate of Trivandrum Medical College in Kerala, India. After working in India, he emigrated to the United States.

A full eulogy written by Dr. Velandy Manohar can be read here.

News from the APA

APA Statement on Shooting at Club Q Nightclub in Colorado Springs

Washington, D.C. — We are deeply saddened to hear of the shooting at Club Q Nightclub in Colorado Springs and mourn the lives of those who were lost and send support to those recovering from injuries. Our hearts go out to the families and friends of the victims, and we urge whoever may need it to seek mental health support in the aftermath of this tragedy.

Hate has no place in America. Violence based in hate is abhorrent. Bias toward LGBTQI people, whatever form it takes, hurts mental health. We stand opposed to laws and rhetoric that discriminate against this community, whether it is promoting dangerous conversion therapy or restricting provision of health care services to trans or gender-diverse individuals...