Wiki Need help!

[Colliemom]

Hi
So I have never done coding for patients in a psych unit before, and I was just asked for info I do not have...

We recently took over billing/coding for a Nursing home/hospital. This particular facility is both a nursing home and a hospital with an acute care unit and a psych unit. We are getting denials for our patients who are in the psych unit. So we are wondering, when a psychiatrist admits a patient to the psych unit, is it a requirement to call in an internist to document the history, physical exam and MDM?

What about the patients who are in the psych unit, who develop a separate medical problem such as a UTI, pneumonia, flu, etc? When our providers are seeing these patients in the psych unit, for a condition unrelated to their psych dx, shouldn't our providers be able to bill for their services? (these are getting denied as well)

 

[thomas7331]

A psychiatrist is a licensed physician so they may admit a patient and perform an admission H&P as long as they have hospital privileges. There should be no need to have an internist do this unless in your facility there is a specific policy or local regulation that requires it. If a medical problem occurs or is identified, the attending physician/psychiatrist would normally order an internal medicine consultation and then the consulting physician would follow the patient during the stay until no longer needed. These visits are billable, assuming supported by documentation, of course. What kind of denials are you seeing - what are they being denied for?