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

Resources

View reason code list, return to Reason Code Guidance page.
 

Last Updated May 22, 2018