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Which billing code provides services "on behalf of" or "for" the client?
Case Management Brokerage (94510- CMB)
Writer traveled from the office to client’s home for a scheduled appointment. Client was not home. Writer waited 10-15 minutes and made several attempts to reach client by phone while waiting. Writer returned to the office.
What billing code should be billed?
No-show Client (90500)
What needs to be included with every single progress note?
A Plan.
What are two billing codes in which interventions are used to improve a client's symptoms and functioning skills?
Rehab (94000) and Therapy (97010-97030)
What is the minimum number of objectives that should be in a client plan?
2
You and the housing specialist go out to see the client and link the client to a couple apartments that are available.
Which billing code should be used for this service?
Case Management Brokerage
Writer made a phone call to a new client at Palmer to schedule first face to face appointment for the intake appointment. Writer provided information about the program and what types of services are offered. Writer coordinated a meeting date and time for the appointment.
What billing code should be billed?
Eng 01- Engagement
What billing code would you use for this service?
Engagement Attempt (22222)
"Provider staff efforts to engage beneficiaries prior to the initial face to face when no face ot face or real time phone contact is made. This may include but is not limited to the following activities: Leaving a message regarding setting up an initial assessment appt, writing a letter with general info about your services offered, or driving to the beneficiary's known whereabouts or home for the purpose of engaging the beneficiary in services."
You receive an unexpected phone call from a Room and Board operator, who states that the client is needing immediate help because she is suicidal and is threatening to jump off her balcony. The room and board operator states that client is open to talking to someone from her team. The R&B operator puts the phone on speaker and asks that you talk to the client. You engage with the client and begin asking the client about her dog. The client and you talk about how much the client loves her dog and how sad the dog would be without her.
What billing code would you use for this service? And why?
Crisis Intervention (95510)
Reason: Client required an IMMEDIATE intervention and was in crisis. This service was also UNPLANNED.
G: Writer met with client at the office in order to review the client plan. Clt was open to reviewing the plan. The clt’s goal is to manage mental health symptoms in order to maintain stable housing and income and improve relationships with others.
I: Writer reviewed client’s objective and shared how the first objective is to increase communication skills, utilize I statements, reflective listening and practicing calmness when angry. Writer reviewed the interventions and client’s role in his treatment.
R: Client agreed to attend art group in order to increase support that is reflective of client’s interests. Client agreed to the clt plan and signed the plan. Client was offered a copy of the plan and accepted a copy.
P: Writer will continue to support client in mental health tx goals.
What billing code should be billed?
Plan Development (code 98500)
[for a new client] Prior to the client plan, what is the only reason we would bill CMB?
For housing related needs. We are not able to bill CMB prior to the client plan for linkages/referrals unless it is housing related.
You meet with the clt in the office to gather information for AHQ, MSE, and CODA and then they also meet with their manager to complete a LOCUS, and complete all of these items in AVATAR the same day- this would all be combined into one service time.
How many progress notes should be written from this service? AND what billing codes?
1 progress note should be written- Assessment in office (code 93030)
What word does the S in GIRPS stand for? And what needs to be included for that section?
S stands for Status.
Housing and Financial Status
G: Clt will decrease AOD (alcohol, opiates, meth) use from 7 days per week to 5 days per week. Clt reports that he had been sober for 1 week, but relapsed and has used for the past two days.
I: Met w/ clt at his home. Explored coping skills (watching tv, taking a walk, smoking a cigarette, hanging out w/ sober friends) and activities clt can utilize to refrain from using AOD. Encouraged clt to engage in TLCS art group and AOD services. Discussed clt getting a pet as a motivation to be sober to take care of it.
R: Clt was well groomed, but reported he was not feeling well as he was hung over. Clt participated in brainstorming coping skills he needs to make more of an effort to use in order to stay sober. Cl not willing to participate in TLCS AOD services, but reported he will think about attending art group. Clt talked about wanting to get a dog. Clt was receptive to feedback around responsibilities that go in to caring for a dog. Clt reported he understands the responsibilities and believes that owning a dog may help him to stay sober because he knows the dog will depend on him to care for it.
P: Continue to encourage clt to engage in AOD services. Continue to support cl in developing coping skills to help decrease AOD use.
S: Clt is currently housed and maintaining his apartment.
Which billing code should be used for this service?
Rehab (94000) or Therapy (97010-97030)
What information do you include in your plan development note for obtaining the client's signature?
Hint: 3 things should be included
1. Client agreed to the plan and signed it
2. You offered a copy of the clt plan to the clt.
3. Whether or not clt accepted a copy of the plan.
Writer spoke with Housing Program Manager, Latesha Pierce, regarding client housing situation. Writer gathered information on client's behald with respect to available resources and supports to assist client with payment of late fees for his rent. Writer spoke with housing program manager on behalf of client concerning client's recent receipt of a payment invoice due 7/19/21, with the caveat that if payment is not made eviction proceedings will begin. Housing program manager provided information on hos writer can proceed to best support client through this.
Plan: Writer will connect with client and utilize information gathered during this meeting to best support client.
Which billing code should be billed for this service?
Case Management Brokerage (94510)
What information should be included in a Assessment note where you gathered information for an AHQ?
- medical conditions and how they are being treated
- possible linkage needed for PCP, Dentist, and/or Vision
Which billing code can only be used once per day, per client, per staff?
Assessment in Office (93030)
You take a client to the doctor's office and end up waiting for two hours. The client and you discuss and practice for 30 minutes some mindfulness activities. That is the only time you are engaged in conversation with the client because the rest of the waiting time, the client wants to sit in silence.
How many notes should you write and which billing codes would you use?
2 progress notes
1. Rehab (94000)
2. MHSA Client Services and Support (28045)
Which 7 billing codes can be billed prior to the client plans?
These are the only codes that can be billed before the initial client plan is finalized:
Assessment
Plan development
Case management
MHSA codes
Crisis Intervention
Engagement
Engagement Attempt
Please give me an example of a Case Management Brokerage Progress note.
Best CMB note.
PSC met with clt at their house to gather information for CORE and Clt plan, completed a LOCUS with their manager but did not enter any information into Avatar the same day.
How many progress notes should be written and what billing codes?
Three separate service codes would be used:
-Assessment in office (93010) for the LOCUS time with manager
-Assessment in the community (93020) for the CORE at the clt’s home
- Plan development (98500) for Clt Plan
G: To help client reduce symptoms of depression by encouraging client to socialize, exercise, and stay busy.
I: Writer met with client's girlfriend (ROI on file) at the office to discuss with her client's current progress towards reducing his depressive symptoms (isolation, low self-esteem, extreme sadness). Writer asked the girlfriend questions about client's homework from the past week and the progress client has made. Writer actively listened and encouraged the girlfriend for being a great support to the client. Writer gave the girlfriend some feedback on how she is making statements to client and how the client might interpret them. Writer encouraged the girlfriend to give client choices and how to empower and encourage him to get out of the house.
R: Clt's girlfriend confided that client did not leave the house in the last week. Clt's girlfriend shared how she threatened client to see his friends or be forced to cook for himself the next week. The girlfriend expressed how frustrated she's become with encouraging the client to help himself. Clt's girlfriend was open to the feedback and agreed that threatening someone might not be a good motivator for change. The girlfriend agreed to try the other approaches.
P: Writer plans to meet with the girlfriend next month on 6/6/2021 at 3 pm at the office to follow-up new approaches for motivating the clt to leave the house.
S: Clt is housed and has GA.
Which billing code would you use for this service?
Collateral in office (95030)
"A collateral service is contact with a significant support person in the life of the client with the intent of improving or maintaining the mental health status and achieving the goals of the client's Service Plan/goals." ROI should be on file and mentioned in PN.
Please give me an example of a rehab or therapy progress note including the ANSA.
1. The client
2. The staff member completing the annual with the client (PSC/therapist).
3. The support person identified in the client plan