Do I always bill for a re-evaluation for Part B when I am discharging?
Answer
No. You do not have to. The re-eval code needs some requirements met when billing with it. Re-eval would be appropriate when you truly are re-evaluating. Perhaps there has been a change in condition, function, long-term goals, your treatment plan, or something has come up that requires you to re-evaluate this patient. Just because you are doing a discharge summary or an updated plan of care or 701, does not mean that you would bill a re-eval. To that point, there was a time period in our therapy history when that is exactly what we would have done. If you go back to the LCD for your MAC, it will probably spell out very specifically what they want to see to justify the re-eval.
Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, OTR/L
Kathleen Weissberg, OTD, OTR/L, in her 25 years of practice, has worked in adult rehabilitation, primarily in long-term care as a clinician, manager, researcher, and most recently as Education Director with Select Rehabilitation where she oversees continued competency and education for close to 12,000 therapists. In her role, she conducts audits and provides denials management and quality improvement planning training for more than 700 LTC sites nationwide. She also conducts compliance, ethics, and jurisprudence training to therapists. Kathleen has authored several publications that focus on patient wellness, fall prevention, dementia management, therapy documentation, and coding/billing compliance.
Related Courses
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