Documentation requirements
Based on the Patient’s Plan of Care (POC) or other available medical documentation, the following scheme should be followed when billing sessions.
These include medical conditions that have supporting documentation that extra sessions are reasonable and necessary (e.g., through documents from recent hospital care, office visits, dialysis progress notes or MCP visits).
Please note that the POC and other supporting medical documentation to justify any of the line item sessions will be most important and may be requested.
Please see L37575 for Documentation Requirements and Utilization Guidelines.
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
| Code | Code system | Status in this policy |
|---|---|---|
| 90999 | HCPCS | Covered |
| E83.30 | ICD10CM | Covered |
| E83.39 | ICD10CM | Covered |
| E87.20 | ICD10CM | Covered |
| E87.21 | ICD10CM | Covered |
| E87.22 | ICD10CM | Covered |
| E87.29 | ICD10CM | Covered |
| E87.5 | ICD10CM | Covered |
| E87.70 | ICD10CM | Covered |
| E87.71 | ICD10CM | Covered |
| E87.79 | ICD10CM | Covered |
| I30.0 | ICD10CM | Covered |
| I30.1 | ICD10CM | Covered |
| I30.8 | ICD10CM | Covered |
| I30.9 | ICD10CM | Covered |