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Do You Bill for a Re-Evaluation for Part B When Discharging?

Kathleen Weissberg, OTD, OTR/L

April 21, 2015

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Question

Do I always bill for a re-evaluation for Part B when I am discharging?

Answer

No.  You do not have to.  The re-eval code needs some requirements met when billing with it.  Re-eval would be appropriate when you truly are re-evaluating. Perhaps there has been a change in condition, function, long-term goals, your treatment plan, or something has come up that requires you to re-evaluate this patient.  Just because you are doing a discharge summary or an updated plan of care or 701, does not mean that you would bill a re-eval.  To that point, there was a time period in our therapy history when that is exactly what we would have done.  If you go back to the LCD for your MAC, it will probably spell out very specifically what they want to see to justify the re-eval. 


kathleen weissberg

Kathleen Weissberg, OTD, OTR/L

Dr. Kathleen Weissberg, (MS in OT, 1993; Doctoral 2014) in her 25+ years of practice, has worked in rehabilitation and long-term care as an executive, researcher and educator.  She has established numerous programs in nursing facilities; authored peer-reviewed publications on topics such as low vision, dementia quality care, and wellness; has spoken at numerous conferences both nationally and internationally, for 20+ State Health Care Associations, and for 25+ state LeadingAge affiliates.  She provides continuing education support to over 17,000 therapists, nurses, and administrators nationwide as National Director of Education for Select Rehabilitation. She is a Certified Dementia Care Practitioner and a Certified Montessori Dementia Care Practitioner.  She serves as the Region 1 Director for the American Occupational Therapy Association Political Affairs Affiliates and is an adjunct professor at both Chatham University in Pittsburgh, PA and Gannon University in Erie, PA. 


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