Guide to H0031, H0032, H2014, Mental Health CPT Codes [2023]

Guide to H0031, H0032, H2014, Mental Health CPT Codes [2023]


CPT codes, or Current Procedural Terminology codes, are medical coding terms that seem to have permeated every aspect of behavioural health. They are at the core of the proper coding and billing of all insurance claims. Most therapists and professionals I worked with who were paid by insurance knew very well what a CPT code was before they were ever introduced to it, and most experienced audits and denials of care due to incorrect CPT codes. Thus, from my experience, it is imperative that all professionals understand the key CPT codes related to mental health, such as H0031, H0032, H2014 and so on, as well as their respective descriptors, billing guidelines, and modifiers. This article aims to aid a behavioural health professional in avoiding many of the pitfalls involved in understanding and properly billing for one’s work using the most commonly assigned CPT codes.

H0031 CPT Code Description and Billing Guidelines  

H0031 describes a coding for Mental Health Assessment by non-physician. This is a service for initial evaluation of a patient’s mental health condition and relevant information included as part of the assessment process. It may include the administration of diagnostic interviews, psychological testing and behavioural observation. [1

Billing Guidelines for H0031: 

– For H0031, you should record how much time you spent on the assessment and describe the services you provided. - Ensure that the assessment is medically necessary and supports the diagnosis. - Follow proper documentation standards, including the patient's history, assessment findings, and treatment plan. - Learn the specific reimbursement criteria that must be submitted to an insurer or payer in order to get paid.

H0032 CPT Code Description and Billing Guidelines 

CPT Code H0032code for Mental Health Services provided by a licensed clinical social worker (LCSW), licensed professional counsellor (LPC), and other mental health professionals.Used to report psychotherapy services furnished to an individual, married or unmarried couple, family, or group. Attention Deficit Disorder (ADD) is the term that is widely used in the United States for problems of inattention, impulsiveness and hyperactivity that have always been known as attention deficit hyperactivity disorder (ADHD). Billing Guidelines for H0032: You must be appreciative of the Code Which Is Not Only Intended To Be Followed But Like Code, Must Be Followed And Enforced And Appreciated, especially when you choose to submit a claim for H0032. Remember: even an Axis I (orientation disorder) patient cannot receive transcranial magnetic stimulation twice daily for an hour over six weeks. - Document the therapeutic interventions, goals, and progress notes to support the services billed. - Using billing codes that satisfy the requirements set by insurance carriers or payers. H2014 CPT Code Description and Billing Guidelines H2014 is a US Current Procedural Terminology (CPT) code for the ‘administration of Psychosocial Rehabilitation Services designed to assist persons with mental health conditions in developing the skills and supports necessary for recovery, rehabilitation, and independent living in the community.’ [1] Billing Guidelines for H2014: Your best efforts in documentong what you did, both pre- and post-disaster, will be rewarded – recording services offered and outcomes using H2014 will allow you to identify patterns, relationships between rehabilitation interventions and goals, pathways to treatment and care outcomes. - Ensure that the services are medically necessary and align with the individual's treatment plan. - Familiarize yourself with any additional guidelines or requirements provided by insurance companies or payers. Modifier HH and Other Relevant Modifiers Modifiers are additional codes that you can use to provide more specific information about services provided, or to indicate that services provided fall into a special category or situation. For example, modifier HH is used to describe the identification of mental health services by a licensed clinician in a Health and Behaviour Assessment and Intervention (HBAI) setting [1]. Be sure to use modifiers only if your insurance company (or payer) guides you to do so.

CPT Code H0032 and H20 

FAQs 1. What is the difference between H0031 and H0032? H0031 is for Mental Health Assessment while H0032 is used for Mental Health Services, including visits for psychotherapy services provided by clinical social workers, professional counsellors and other mental health practitioners. 2. Can H0032 be used for group therapy sessions? - Yes, H0032 can be used for individual, couples, family, and group therapy sessions [2] 3. Are there any specific guidelines for billing H2014? – Yes, while billing for H2014, all the services that can be provided for the rehabilitation intervention must be documented and should have to make a part of the treatment plan. Conclusion Intelligent use of mental health CPT codes is essential for coding compliance and reimbursement purposes. We hope that this guide was useful in detailing the descriptions and billing guidelines for codes H0031, H0032 and H2014. As a reminder, always refer to code-specific guidelines from your insurance company, or payer, for more information and clarification. Also, as noted earlier, be sure to document services accurately and stay informed of any code changes or updates. Note: This information is taken from the sources, which may vary depending on when it was last accessed or published (this information is current as of September 2021). Any information on coding provided in the resources - codes, tables, guidelines, etc - should be used to supplement existing resources, never overwrite them.


References:

1. Mental Health CPT Codes: The Definitive Guide [2023] - TheraThink.com. Retrieved from [here]

2. CPT Codes for Psychotherapy and Other Psychology Services - Psych Central. Retrieved from [here]




http://www.cms1500claimbilling.com/2016/08/cpt-code-h0031.html

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