Billing > Facility Billing

UB04 billing PHP and 90792/90791

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Sbauman@changestreatmentc:
Carriers are paying these grouped on UBO4 for our facility. The rev code for Initial evaluations was 900, now that rev code is rejecting.  :'(

ABMUtah:
I am writing you not because I have the answer to your question but because I am having issues of my own regarding PHP claims.  I cannot seem to get them right.  I am trying to figure out what the difference is between PHP and IOP claims?  Are you using modifiers with your HCPCS code?  I keep getting mine kicked back and denied for lack of information between boxes 42-49.  Not sure where the problem is.  If you know any information about this it would be very much appreciated. Thank you!!

Michele:
IOP - Intensive Outpatient
PHP - Partial hospitalization

If these are getting kicked out at the clearinghouse level I would start by contacting them.  Ask for a specific denial.  They really should be able to provide more information.

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