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Mental Health Assessment in 2 parts??

L

laurabee

Networker
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43
Patient came in for MHA and plan from QMHP (H0031 & H0032) on two different days because the provider had to do the assessment and plan in 2 parts due to time constraints of provider's schedule. Provider is wanting to bill H0031 & H0032 twice, once for each day patient was seen (documentation is labeled "part 1" and "part 2" and provider documented that they spent an hour on services each day), and I see that these codes can be billed 4 times per year, but it doesn't seem right to me to bill for this because of time constraint on the provider's part. Even if it's reimbursed, that potentially bars other providers from being paid for the same services later in the year. I've searched everywhere but I can't find any guidelines on this.
 
Does the assessment part 1 and part 2 meet the documentation requirements? If not then they would be considered as one unit or encounter regardless of the amount of time it took to complete the assessment.
 
H0031

laurabee said:
Patient came in for MHA and plan from QMHP (H0031 & H0032) on two different days because the provider had to do the assessment and plan in 2 parts due to time constraints of provider's schedule. Provider is wanting to bill H0031 & H0032 twice, once for each day patient was seen (documentation is labeled "part 1" and "part 2" and provider documented that they spent an hour on services each day), and I see that these codes can be billed 4 times per year, but it doesn't seem right to me to bill for this because of time constraint on the provider's part. Even if it's reimbursed, that potentially bars other providers from being paid for the same services later in the year. I've searched everywhere but I can't find any guidelines on this.
Click to expand...

If it takes two days to complete it should be coded ones on the day of completion.

http://www.cms1500claimbilling.com/2016/08/cpt-code-h0031.html It says the 'completed' here, so if it took two days to complete, it would mean two incompletes could not be billed.

I was trying to find the LCD on H0031...but it wouldn't pull up. Here are all other BH codes with their cms rules

https://www.cms.gov/medicare-covera...tHcpcsCode=90837&kq=true&bc=IAAAACAAAAAAAA==&
This might come in handy for all other behavioral health codes.

Hope this helps,
Barbara
 
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