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Wiki CPT 90847 for PHP

Thread starter gbrunow0828
Start date Nov 17, 2010

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gbrunow0828

Guest

Nov 17, 2010

We are receiving a claim edit for CPT 90847 stating states ‘mental health code not payable outside the partial hospitalization program' . We have billed this code, on these same patients, and been paid up until this last visit. I read the LCD info and it states this code can be used for both PHP and outpatient Psych visits but you have to differentiate between the two by using condition code 41 which signifies PHP. Can anyone help?

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