Billing and Coding: Psychiatric Inpatient Hospitalization

Billing for psychiatric inpatient hospitalization is covered when services meet the reasonable and necessary criteria of LCD L33975 and the medical record supports the selected ICD-10-CM and CPT/HCPCS codes. Required documentation includes a timely initial psychiatric evaluation within 24 hours, a multidisciplinary treatment plan developed within three program days with measurable outcomes and weekly updates, and separate, signed progress notes for each significant service; failure to meet documentation or timing requirements may result in denial or noncoverage.

"Psychiatric inpatient hospitalization is covered when it meets the reasonable and necessary requirements of LCD L33975 and the medical record supports the selected ICD-10-CM code(s) and CPT/HCPCS s..."

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