Documenting services in inpatient psychiatric facilities.

Publication: Getting Paid in Behavioral Healthcare

Publication Date: 01-OCT-05

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COPYRIGHT 2005 Manisses Communications Group, Inc.

As inpatient psychiatric facilities (IPF) transition over the next months toward a prospective payment system (PPS), it may be more important than ever for providers to document services in a manner that reflect the regulations governing:

* Medical necessity;

* Active treatment;

* Treatment planning, and;

* Certification and recertification.

Medical necessity: Documentation must show that the patient requires intensive, comprehensive, multi-modal inpatient treatment including 24 hours per day of medical supervision and coordination because of a mental disorder.

The need for 24 hours of such services may be due to the need for patient safety, psychiatric diagnostic evaluation, potential severe side effects of psychotropic medication associated with medical or psychiatric co-morbidities, or evaluation of behaviors consistent with an acute psychiatric disorder for which a medical cause has not been ruled out.

Patients must require inpatient psychiatric hospitalization services at levels of intensity and frequency exceeding what may be rendered in an outpatient setting, including psychiatric partial hospitalization. There must be evidence of failure at, inability to benefit from, or unacceptable risk...

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