Q&A HELP PLEASE!!

[Kim Pressley]

I am extremely confused regarding re-evaluation in therapy/rehab patients. I read in places that re-evaluations can only be charged/coded (using modifier 59) if the status/plan of care has significantly changed; however in other places I read that a re-evaluation is required every 30 days by CMS??? Does this mean that CMS requires the re-evaluation but it cannot be charged for unless there has been a significant change. Please help me understand this and if possible provide concrete documentation. I am working together with our Rehab facility to try to understand when we can bill for these re-evaluations and, of course, need to be able to back up with guidelines.

As always, THANKS For your help!

LOOKING FORWARD TO THE WEBINAR THURSDAY

Kim

 

[Kim Pressley]

Thanks for your consideration, but after much research I have arrived at the conclusion that the 30-day reassessments are required as standard of care and are not billable; only when patient status changes to the point of requiring a new plan of care (requiring signature of attending md) is the reevaluation billable. Thanks again!

Kim

 

[Laureen]

Great sleuthing - thanks for coming back to share!!!