Wesleyan Holiness Denominations, Male Skincare Influencers Australia, Articles OTHER

I've been told most folks are billing 99214 + 90833 for 30-min follow-ups to maximize RVUs - is this legit? Dont worry if you havent done an exam, as long as the appointment is 25 minutes and youve completed the other two elements! Mentegram has a library full of online tools, such as the PHQ-9, that range from detailed surveys to simple sliding scales. No: One stable chronic illness, one acute uncomplicated illness, and one acute uncomplicated injury. PHI3}lpT:[t^:?39fWO6T8vRb2qMJ4a{7ULJ4jTv)JWLh!lT{ZLEMkSr:#+7gNI^lYfvKRz{U_vjUyotibOrLN)] Y]+>Ex>+:RWupdoc*et68ef|g|/w7.-,Nmt"iIDT Decision about major elective surgery without identified risk factors for patient or procedure. Narcosynthesis for Psychiatric Diagnostic and Therapeutic Purposes (e.g. This procedure involves the administration, usually through slow intravenous infusion, of a barbiturate or a benzodiazepine in order to suppress inhibitions, allowing the patient to reveal and discuss material that cannot be verbalized without the disinhibiting effect of the medication. General Coding. Our data is encrypted and backed up to HIPAA compliant standards. 0% 99213 for follow ups. The 3 Month (100 Day) MCAT Study Schedule Guide: 2022 Edition, https://www.ama-assn.org/system/files/2019-06/cpt-office-prolonged-svs-code-changes.pdf, All resources are student and donor supported. Subscribe . This guide will teach you the most common psychiatry CPT codes, psychiatry addon codes, psychiatry evaluation and management codes, and how to bill psychiatry CPT codes. &k%9=[bYF?g7CHx\V;5D If so, code it as a level 4 using MDM. Check BP 3 times a wk, avoid salt, continue to limit alcohol to 2 drinks a day or less. Code it as a level 4 using total time. hj0o@B6kl#Cb[Hn&[3`0Y9G7s CPT Code 99213 is a level three code that should be used for an established patient. Individual Psychophysiological Therapy Incorporating Biofeedback. Hopefully, this will encourage psychiatrists who have fled insurance networks to return to themyou can now be assured of a robust income with an insurance-based practice, even if you choose to see many of your patients for therapy. E/M Coding and Documentation Education. 90792 Psychiatric Diagnostic Eval 99204 Level 4 New Patient Office Visit (Typical time 45 minutes) 99205 Level 5 New Patient Office Visit (Typical time 60 minutes) Follow-up Psychiatry appointments. Did you see the patient for a level 4 problem and either prescribe a medication, interpret an x-ray (or ECG), or order/review three tests? Review of prior external note(s) from each unique source*, Review of the result(s) of each unique test*, 1 or more chronic illnesses with exacerbation, progression, or side effects of treatment, 1 undiagnosed new problem with uncertain prognosis, Assessment requiring independent historian(s), Independent interpretation of a test performed by another physician/other qualified health care professional (not separately reported), Discussion of management or test interpretation with external physician/other qualified health care professional/appropriate source (not separately reported), Decision regarding minor surgery with identified patient or procedure risk factors, Decision regarding elective major surgery without identified patient or procedure risk factors, Diagnosis or treatment significantly limited by social determinants of health, 1 or more chronic illnesses with severe exacerbation, progression, or side effects of treatment, 1 acute or chronic illness or injury that poses a threat to life or bodily function. One acute illness with systemic symptoms (e.g., pyelonephritis or pneumonia). I probably wouldn't feel comfortable consistently coding 99214+90833 for a 20 min visit, but 30 minute visits? Start: Dec 1, 2022 Get Offer. This code would be best used to denote this service. First, a chief complaint must be included in each note. mq:}=c0uijWjFOj["aw|te4voMxXuNte;OhV ][:eW-^2{];N>$hfRcTeklIf9)V*uWrjmCL:xFPjw\e If you're a psychiatrist seeing a follow-up patient for 30 minutes, there is almost always a way to justify that more than half of that session was spent doing therapy. If you experience any issues or have forgotten your Username, contact apa@psych.org or call APA . 2023 Carlat Publishing, LLC and Affiliates, All Rights Reserved. You can call, text, or email us about any claim, anytime, and hear back that day. Breathing is nonlabored. Personal belief: If you spent the time, effort and money to go through psychiatry residency +/- fellowship, you should be able to decide if you're doing "16+ minutes of psychotherapy" - not the insurance company. CMS has finalized the following services to be added to the Category 1 list: Group psychotherapy (CPT code 90853) Psychological and neuropsychological testing (CPT code 96121) . The overall level of the visit is determined by the highest levels met in at least two of those three elements. Tightly clustered appointments leave very little room for error or miscalculation. Denny has interviewed hundreds of mental health practitioners to better understand their struggles and solutions, all with the goal of making the professional side of behavioral health a little easier, faster, and less expensive. Many EHRs have time calculators that will show the amount of time you have had the patient's chart open. This modifier is used when the work associated with the service provided is greater than that usually required for the listed code. Learn how to offload your mental health insurance billing to professionals, so you can do what you do best. Make sure to review our list of the most common insurance billing procedure codes for psych services: Here is a downloadable Psychiatry CPT Code Cheat Sheet PDF: If you need help choose the right CPT code to use for your insurance claims, we help translate billing into English with our mental health billing service. Laboratory: strep screen negative, strep culture pending. It offers higher revenue/reimbursement than some similar CPT codes, including CPT Code 99213. Free Account Setup - we input your data at signup. You want to get paid quickly, in full, and not have to do more than spend 10 or 15 minutes to input your weekly calendar. PHARYNX: tonsils 2+ red s exudate. The physician may choose to prescribe a medication for the patients behavioral health ailment. Also keep in mind that decision making does not always need to include detailed exams. All Rights Reserved. No cervical adenopathy. EXAMPLE 2. Some providers bill with CPT Code 99214 all the time. w-UQwk!fKcHZiquM!3FduW *-1UA-q3%uk.4[4{yM`WT:'!^`UU.G*H1y[U General - Negative for fatigue, weight loss, anorexia is it possible to bill 99214+ 90833 for a 20 minute visit, or is that likely cheating? CPT DOCUMENTATION REQUIREMENTS FOR E/M CODE 99214 WITH AN ADD-ON PSYCHOTHERAPY SERVICE When an E/M office visit is provided together with an add-on psychotherapy code (90833, 90836 or 90838), the E/M code must be documented based on elements, not time. Another way to simplify coding level 4 visits is to recognize that ordering labs, x-rays, ECGs, and medications (prescription drug management) often signals level 4 work, while using independent historians, discussing care/studies with external physicians, and providing care limited by social determinants of health are not used as often to code level 4 visits. Documentation of total time is fairly straightforward: just note how much time you spent on the visit that day. pHK8`Anbe2D`j2^}Wq jRMu endstream endobj startxref However, because this is not a service provided face-to-face with a patient, Medicare will not reimburse for this code either, and clinicians should verify coverage by other insurers. The activities covered by this code include physician visits to a work site to improve work conditions for a particular patient, visits to community-based organizations on behalf of a chronically mentally ill patient to discuss a change in living conditions, or accompaniment of a patient with a phobia in order to help desensitize the patient to a stimulus. The problems are usually of a moderate to high complexity. No cervical adenopathy. Technology: Making Todays Therapy Way More Engaging. Copyright 2021 by the American Academy of Family Physicians. ]=-=LTq;{E`E0T4w@qyG8JEBv)aE{;FAA!es/QE00BB HIpJ`;h%0p\@n Once you know the ins and outs of both codes, choosing which one to bill is actually quite simple. Trouble is if even one of these folks shows up and against expectations everything is -not- copacetic this time, you might end up taking 30-40 minutes dealing with the situation. You can call, text, or email us about any claim, anytime, and hear back that day. One acute complicated injury (e.g., concussion). Patients with 2 problems: Document the problems, one ROS item, and the prescription of a medication. EYES: Fundi benign. Neurologic - Negative for paresthesias Office of Corporate Compliance - University of Chicago Medicine Discussion of the patient's management or test results with an external physician (one from a different medical group or different specialty/subspecialty). The detailed or expanded history can be simply derived from past charts of the existing patient. 668 0 obj <>stream Taking losartan every day. Others are afraid that they wont be reimbursed for it. You want to know you can call your billing admin, a real person you've already spoken with, and get immediate answers about your claims. Here is a list of the most common evaluation and management psychiatry CPT codes: Please check out our extensive guide to 2021 reimbursement rates for psychiatrists. A great example of a primary care doctor using CPT Code 99214 is when an existing patient comes in for a routine health examination for chronic pain. Group 1 Paragraph. It is a HCPCS Level II code (CPT codes are HCPCS Level I), part of the HCPCS system used by Medicare and Medicaid. Consider hiring a team of billing experts at Therathink. (2;4222;;;;;;;;;;;;;;;;;@@@@@;@@@@@@@@@@@@@@@@@@@@@ x " Autism spectrum disorder, ADHD, other specified anxiety disorder. You can call, text, or email us about any claim, anytime, and hear back that day. "#$%&'()*3456789:CDEFGHIJSTUVWXYZbcdefghijrstuvwxyz ? Subjective: 23 y/o female presents for recheck of depression, also complaining of sore throat and ankle sprain. Laboratory: UA TNTC, WBCs 4+ bacteria. Remember that you only need two of the three elements, so you can bill for taking history and medical decision making. This will help you keep track of time while you're reviewing the chart before the visit, performing the exam (if you always open the chart at the beginning of the visit and close it at the end of the encounter), and making notes after the visit. Please refer to their documentation here: https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Practice-Management/Coding-Reimbursement-Medicare-Medicaid/Coding-Reimbursement/cpt-primer-for-psychiatrists.pdf. You'll always be able to get in touch. Cardiovascular - Negative for chest pain, orthopnea or PND Labs: BUN 12, creatinine 0.8, HGBA1C 6.8, spot microalbumin/creatinine ration is 28 mcg/g; LDL 77 For patients who are chronically stable, just want refills in 10 minutes, and don't want supportive therapy, it seems like a waste of time to reserve them a full 20 or 30 minute slot. PDF Science Health Science Psychiatry . Subjective: 47 y/o male presents for a BP recheck. Due to some of their similarities, many healthcare providers can experience confusion when deciding which one to bill. TheraThink.com 2023. EXAMPLES ONLY: Prescription drug management Decision regarding minor surgery with identified patient or procedure risk . Here are the rates that Medicare believes are the commercial insurance rates for these services (this is not the Medicare rate for 99214): These rates are adjusted down and reflect what Medicare has deemed are average rates for most psychiatrists across the United States. But then you cant bill a therapy add on code, I have always been told the MDM is implied as the driving factor. I think technically MDM (medical decision making) is not required to be 1 of the 2 currently, but that will change for Medicare starting January 2021. Unlisted Psychiatric Service or Procedure. examples of E/M codes across specialties An attempt was made to revise the office and other outpatient examples Not enough specialties participated CPT decided to hold off on example revisions for the new code definitions For now, examples related to these code have been deleted Nonetheless, AACAP and APA collaborated on Yes: One chronic, uncontrolled illness. Glyburide 10 mg po bid However, behavioral assessment tools may be utilized to ensure that the anxiety is still at a mid-level, with no additional risk factors. CPT Code 99214 can only be used for an established patient's office visit, and it is a level four code. 6+ Psychiatric Progress Note Examples 1. Hypnotherapy may be used for either diagnostic or treatment purposes. We will offer you a quick guide on most common psychiatry CPT Codes, explain evaluation and management (E/m) codes, and then provide an exhaustive list of all Psychiatry CPT codes. a psychologist or a psychiatrist) is required. Our mental health insurance billing staff is on call Monday Friday, 8am-6pm to ensure your claims are submitted and checked up on with immediacy. When the pain occurs, the patient may also experience anxiety, which is being treated with a low-dose anxiolytic medication. depression or anxiety), requiring further testing or a new medication prescription. There are no new diagnosis or medications prescribed. x;EO&@O. Going forward, the username you use to log into the system will always be the same as your primary email address on file. e !1AQ"Taq2BS34CDR While not all insurance companies accept the code 99214, many do. They can be used to increase the complexity of visits and thereby qualify for billing with a higher code (e.g. Ask us how you can start billing with CPT Codes 99213 and 99214, as well as with other codes today! Eligibility & Benefits Verification (in 2 business days), EAP / Medicare / Medicaid / TriCare Billing, Month-by-Month Contract: No risk trial period. If youre not changing anything Im willing to bet the vast majority of our patients have 3 or more problems. History is rarely one of the 2 elements for me for 99214. if you have a patient with 3 or more stable problems or 1 stable problem and 1 worsening problem that is enough for moderate complexity MDM. hmk0`_%ttuPkMjH[wDNKdt:$aDg&a`aDfsk % pRZs40D2T&UYP* Its important to keep this in mind when working on your mental health insurance credentialing applications. Tripped over dog and turned ankle in. This patient may have had mild back pain for three or four years, being treated with muscle relaxants. TMs: Benign. 99214 : 3 chronic . My cost is a percentage of what is insurance-approved and its my favorite bill to pay each month! Messages. and 99214) High (99205 and 99215) During an encounter with the patient, multiple new or established conditions may be . Objective: T 100.2, P 96, R 18, BP 110/70. The good news is that it is not only for mental health providers or therapists. Revised Prolonged Services code 99417, new 99418, deleted codes 99354-99355, 99356- 99357. As private practitioners, our clinical work alone is full-time. 99214: 25: 30-39: 99215: 40: 40-54: . HEART: S1 and S2 no murmurs. This includes time spent with the patient, but also time spent before the visit reviewing the chart and time after the visit documenting the visit, etc. Tightly clustered appointments leave very little room for error or miscalculation. Your access portal for updated claims and reports is secured via our HTTPS/SSL/TLS secured server. Remember it is not just severity of condition alone that is going to get out to 99215, you need the lab/consulting other providers/. Do you think reviewing medical records and intensive monitoring of significant adverse medication effects leaves a lot of wiggle room to justify a 99215? LUNGS: Clear. Physical Exam HEART: RRR. New prolonged service codes capture additional time spent with patients This is not an exhaustive look into which E/M codes to use; please refer to our documentation and guidelines section later in this article. Denny and his team are responsive, incredibly easy to work with, and know their stuff. I actually think its hard to have history consistently be the item because its not always necessary to have an ROS or to have PSFH in progress notes. M0064 should only be used for the briefest medication check with stable patients, Source: https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Practice-Management/Coding-Reimbursement-Medicare-Medicaid/Coding-Reimbursement/cpt-primer-for-psychiatrists.pdf, Other Source: https://www.aacap.org/App_Themes/AACAP/docs/clinical_practice_center/business_of_practice/cpt/2018_CPT_module_revised_March_2018.pdf, e/m codesevaluation and management codesmental health billingpsych codespsych cpt codespsychiatry billingpsychiatry codespsychiatry cpt codespsychiatry reimbursement rates. Another question re: coding - considering joining a company that exclusively does 30 min follow-ups and 1 hr news (which is what I prefer anyway) but compensation will eventually be RVU based. Reach out now for more information on our services. Brief Office Visit for the Sole Purpose of Monitoring or Changing Drug, Prescriptions Used in the Treatment of Mental Psychoneurotic and Personality Disorders M0064 is not, in fact, a CPT code. This modifier is used for procedures that are a combination of a physician component and a technical component. Let us handle handle your insurance billing so you can focus on your practice. They are all part of HCPS, the Healthcare Common Procedure Coding System. B!AYONT;A0ouoO(RV[y;eir70+>pjqt x87{nIo#HdPoeBVX?.vsZ sz2i}c0)5R"!24gB[7S_3p` qUA Cipro 500 mg po bid x 7 days with appropriate precautions. Also, what do you do with people who are, say, six minutes late to their appointment? Preparation of Report of Patients Psychiatric Status, History, Treatment, or Progress (Other Than for Legal or Consultative Purposes) for Other Physicians, Agencies, or Insurance Carriers. However, here's the breakdown for coding the visit based on MDM: Was there a level 4 problem? Total time does not include time spent performing separately billed procedures or time spent by your nurse or other office staff caring for the patient. The code includes the time the physician takes to monitor the patient during the convulsive phase and during the recovery phase. My cost is a percentage of what is insurance-approved and its my favorite bill to pay each month! Was level 4 risk managed? In fact, some medical and psychiatry practice may be "leaving money on the table" when they bill a 99213 code when in fact their service meet the criteria of a 99214 code. This chart helps better visualize the CPT codes by time. In case you needed more reason to be thorough in asking people about sleep problems and substance use, it is if nothing else a very quick way to expand that problem list. Explained that we ask this question because guns in the home increase the risk of suicide, homicide and accidental death, Provided education about the importance of keeping guns locked and separated from ammunition. Therefore, it is no surprise that CPT Code 99214 is used the most frequently for this form of visit. To meet the criteria of a 99214 code / service, a medical service must meed the following requirements: He co-founded a mental health insurance billing service for therapists called TheraThink in 2014 to specifically solve their insurance billing problems. However, these may also be carried out and documented in far less complex methods than originally anticipated. To avoid any pitfalls, lets take a closer look at each code and how it can be used for reimbursement. EXTREMITIES: no edema. 99214 1.50 1.92 28% 99215 2.11 2.80 33% CMS New Codes for 2021 Code wRVU Value . Was level 4 risk managed? NAD. Office or other outpatient visit for the evaluation and management of an established patient, which requires at least two of these three components to be present in the medical record: Its important to note that the presenting problem(s) are moderate complexity. Consultation codes 99242-99245, 99252-99255 have clarifications, and 99241, 99251 deleted. 1037539v1 OUTPATIENT/OFFICE PSYCHIATRIC PROGRESS NOTE COUNSELING AND/OR COORDINATION OF CARE (99214 or 99215) Patient's Name: _____Date of Visit:_____ Interval . Coding should be easier with the removal of the history and exam components, allowing us to focus more on treating our patients. This is a good way to start a note because the reader knows right at . Eligibility & Benefits Verification (in 2 business days), EAP / Medicare / Medicaid / TriCare Billing, Month-by-Month Contract: No risk trial period. Reimbursement for 99214 is more than 99212 or 99213. Reach out for help from us about suggestions! endstream endobj 206 0 obj <> endobj 207 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/Type/Page>> endobj 208 0 obj <>stream It may also include discussing the patient's care with other health professionals or family members, calling the patient later in the day, or ordering medications, studies, procedures, or referrals, as long as those actions happen before midnight on the date of service. How much more do the therapy add-on codes typically add to the encounter? Started on sertraline 50 mg 4 months ago. Insurance Reimbursement Rates for Psychotherapy, Insurance Reimbursement Rates for Psychiatrists, Beginners Guide To Mental Health Billing, Inquire about our mental health insurance billing service, offload your mental health insurance billing, Decision making regarding treatment is moderate complexity, We charge a percentage of the allowed amount per paid claim (only paid claims). These are the basic parameters for coding a level 4 visit based on total time or MDM under the new rules. Severe and profound intellectual disabilities (ICD-10-CM codes F72, F73, and F79) are never covered for psychotherapy services or psychoanalysis (CPT codes 90832-90840, 90845-90849 and 90853). And I always find it very easy to hit a 99214 (and honestly you shouldnt need to see a 99213 in more than 20 minutesso if youre billing 99213s they should be in 20 min slots). Denny has interviewed hundreds of mental health practitioners to better understand their struggles and solutions, all with the goal of making the professional side of behavioral health a little easier, faster, and less expensive. 45-59 mins 99204 30-39 mins 99214 LEVEL 5 60-74 mins 99205 40-54 mins 99215 20 Winooski Falls Way, Suite 7, Winooski, VT 05404 Toll-free: 800-722-7708 The fact that one code provides for additional revenue/reimbursement makes it critically important to thoroughly understood the differences. Performing level 4 evaluation and management (E/M) outpatient visits but coding them as level 3 visits is a costly mistake for family physicians. PERRLA. It cannot be used with a new patient who has no history. Assessment, For a detailed breakdown of this note with tips and advicesee99214 E/M Insight, An established office patient with hypertension, diabetes and a history of dyslipidemia, Repeat renal profile, spot microalbumin/creatinine at next visit, along with cbc, Check LFTs at next visit as well due to ongoing statin therapy, Continue lifestyle modifications and exercise for weight loss. They are all part of HCPS, the Healthcare Common Procedure Coding System. For example, sometimes I'll order a Lithium draw on a patient in the morning and occasionally get results the same day in the afternoon. As private practitioners, our clinical work alone is full-time. Has prior hx of UTIs. Psychiatry CPT Codes are numerous and nuanced. Two stable chronic illnesses (e.g., controlled hypertension, diabetes, chronic kidney disease, or heart disease). LUNGS: Clear. Discussed depression. This curriculum will teach you all you need to know about performing and documenting office-based and hospital-based psychiatry E/M services. These terms or unique code tends to be uniform all around The United States, which helps in effective billing. This code is reimbursed by most insurers. Pt looks ill but not toxic. 99214: Patients with 2 problems: Document the problems, at least 4 symptom "elements" in the HPI (such as severity, duration, timing, and quality), at least 9 items on the mental status exam, 2 ROS categories (not necessarily psychiatric), and social history (such as "spending more time with friends"). The presence of social determinants of health (lack of money, food, or housing) that significantly limit a patient's diagnosis or treatment. However, here's the breakdown for MDM: Was there a level 4 problem? I've been just randomly using 99213 (or 99212 for biweekly visits) and 99214s, because of this fear of using them "too frequently." PHARYNX: Benign. There must be two out of three factors included for proper billing of Code 99214. Any time under 16 minutes of psychotherapy should not be billed as a psychotherapy add on. Clinical example 99213 E/M coding. PHARYNX: nl. Objective: T 100.4, P 88, R 14, BP 125/70. (Note: these changes apply only to regular office visits and not to nursing home or hospital E/M visits.). For a better experience, please enable JavaScript in your browser before proceeding. 99214, the Mental Status Exam must address nine of the following eleven Mental Status elements: Speech Orientation Language Memory Thought Processes Attention . HEART: S1 and S2 w/o murmurs. Add in the unnecessarily difficult insurance billing system and we run the risk of working way over full-time. Feels good. If youre sick of dealing with the hassle of insurance billing, reach out to us for help! This definitive guide will help you avoid under-coding and allow for more accurate billing. Well it depends on how frequently you see pts. I've been in practice since 2019. Objective: T 97.2, P 72, R 16, BP 160/95. We are your billing staff here to help. Psychiatric Evaluation of Hospital Records, Other Psychiatric Reports, Psychometric and/or Projective Tests, and Other Accumulated Data for Medical Diagnostic Purposes. New Patient, Outpatient, In-Office Services CPT Codes: New or Established Patient, Outpatient, Consultation CPT Codes: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service, We charge a percentage of the allowed amount per paid claim (only paid claims). Im 98% 99214, 2% 99215. The problems are typically considered to be of low to moderate severity. Pt denies depressed mood, insomnia, anorexia, loss of pleasure, suicidal ideation, poor concentration, or irritability. Paneled with a bunch of commercial insurances. "*e+aUw=CMIR0GK!ySS$o0mb/yRT1\FU.Mr"/&DE4Wlgp)pLa${yWS#aUG:Ub:TU!tL{yUFdt^TcI}%p6B \ l1N(cLS/35{{s!-BAyiKePio35rJ4@[iF3]c One x-ray or electrocardiogram (ECG) interpreted by you. You can call, text, or email us about any claim, anytime, and hear back that day. Intake / Evaluation (90791) Billing Guide, Evaluation with Medical Assessment (90792). They are distinct from biofeedback codes 90901 and 90911, which do not incorporate psychotherapy and do not require face-to-face time. Trouble is if even one of these folks shows up and against expectations everything is -not- copacetic this time, you might end up taking 30-40 minutes dealing with the situation. Physicians typically spend 25 minutes face-to-face with the patient and/or family. 256. This is due, in part, to more easily achieved factors for reimbursement on this code than with other CPT Codes, including 99214. It's our goal to ensure you simply don't have to spend unncessary time on your billing. Note: We only work with licensed mental health providers. You free me to focus on the work I love!. In my opinion, it's a lot simpler to document in order to meet the history and exam criteria than the MDM complexity. The rules, which took effect Jan. 1, are the most significant changes to E/M coding since 1997 (for more details, see Countdown to the E/M Coding Changes in the September/October 2020 issue of FPM). This guide will also help you find out which codes to pick. This code is for electroconvulsive therapy (ECT), which involves the application of electric current to the patients brain for the purposes of producing a seizure or series of seizures to alleviate mental symptoms.