Documentation

Documentation Reminder: Psychiatry and Psychology Services

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Documentation Reminder: Psychiatry and Psychology Services

National Government Services conducts prepayment reviews on claims for outpatient psychiatry and psychology services. When responding to an ADR from Medical Review, it’s important to pay attention to the documentation that is being requested. Many claim denials have been issued for missing or incomplete documentation in response to an ADR. Based on these findings, providers who render outpatient psychiatry and psychology services should be aware of the documentation requirements for Medicare reimbursement purposes.

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Submitting Documentation

The following documentation should be submitted when responding to an ADR for psychiatry or psychology services:

  • All recent physician orders and progress notes with clear history of why beneficiary is in treatment and how they have progressed with treatment
  • Signed current POC treatment plan stating the type, amount, frequency and duration of services to be furnished including diagnoses and anticipated goals
  • Medical and psychiatric history and physical/history of why beneficiary is in treatment
  • All certification/recertification statements
  • Type and total time spent in psychotherapy
  • Clinic note for dates billed which summarizes diagnosis, symptoms, functional status, focused mental status examination, treatment plan, prognosis and progress to date with signature and credentials of personnel licensed by the state to render service
  • Case management services other than planning ADLs, arranging care, excursions or resolving medical insurance issues
  • Medication management by personnel licensed to prescribe including a review of the medications such as dosage, side effects and response as well as dosage adjustments/changes
  • Documentation to justify medical necessity of services billed
  • Documentation of physician supervision if services provided off site or off facility grounds
  • ABN as necessary

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Provider Actions

  • Share this information with the appropriate departments who may be involved in ordering, providing, billing or reviewing medical records and documentation for these types of services
  • Update any internal procedures or policies with the information in this article and in the associated referenced resources.

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