Reason Code W7029
Reason Code Narrative
PARTIAL HOSPITALIZATION SERVICE FOR NON MENTAL HEALTH DIAGNOSIS.
Common Reason Code Errors
- Condition code 41 is billed for a partial hospital program (PHP) where mental health services are not approved.
- Non PHP revenue codes have been billed on a PHP claim.
- PHP has been billed but no mental health diagnosis is present.
Common Reason Code Corrections
- Verify condition code 41 is billed appropriately
- Verify revenue codes billed are correct and valid for a PHP claim
- Verify all relevant diagnosis codes have been billed to support PHP services provided
- CMS Integrated Outpatient Code Editor (IOCE)
- CMS Internet Only Manual (IOM), Publication 100-04, Chapter 4, Section 260
View reason code list, return to Reason Code Guidance page.
Last Updated May 22, 2018