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 Tue, 03 Mar 2020 11:40:04 +0000