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Early Intervention Services is a mandated benefit in Massachusetts for some plans.
Claim was submitted using the CMS 1500 and lists services provided as H2015-HN and T1024-AJ with diagnosis code 799.9. Documentation provided consists of the fully completed Universal IFSP Form Revised January 2008 (Mass. Dept of Public Health Early Intervention Services).
The documentation indicates the 2 year old patient was seen for assessment of developmental delays and was referred by the mother. There is no physician stmt. Cognitive and language deficits were identified. No indication alcohol and drug abuse are involved; however, H2015 falls within H0001- H2037 which is shown in HCPCS is to be used for Alcohol and Drug Abuse Treatment Services.
How should services be billed for the Initial Assessment and subsequent community services provided?
Is 799.9 the most specific diagnosis since the provider identified the cognitive and language deficits and is providing services according to that determination?
Should the provider have used one of the V-codes for the developmental delay issues identified?
Is there an update or clarifying information concerning the code that indicates H2015 can be used for these Early Intervention services, even when there is no alcohol or drug abuse involved? -- Thank you.
Claim was submitted using the CMS 1500 and lists services provided as H2015-HN and T1024-AJ with diagnosis code 799.9. Documentation provided consists of the fully completed Universal IFSP Form Revised January 2008 (Mass. Dept of Public Health Early Intervention Services).
The documentation indicates the 2 year old patient was seen for assessment of developmental delays and was referred by the mother. There is no physician stmt. Cognitive and language deficits were identified. No indication alcohol and drug abuse are involved; however, H2015 falls within H0001- H2037 which is shown in HCPCS is to be used for Alcohol and Drug Abuse Treatment Services.
How should services be billed for the Initial Assessment and subsequent community services provided?
Is 799.9 the most specific diagnosis since the provider identified the cognitive and language deficits and is providing services according to that determination?
Should the provider have used one of the V-codes for the developmental delay issues identified?
Is there an update or clarifying information concerning the code that indicates H2015 can be used for these Early Intervention services, even when there is no alcohol or drug abuse involved? -- Thank you.