ENP - Important Steps
Important Steps, Inc. – EI Department Social Work/Family Training Division THERAPY MONTHLY LOG Month/Year: _______/________Child: ___________________________EI No.________________ IFSP Freq___Dur. ___IFSP Therapy Type: SW__ FT___ Location: Home ___Daycare___ Facility___Provider’s Name:__________________________ Title/Credentials:___________________________DateDirect ServicesStart TimeDirect ServicesEnd TimeSession Type:R= regularM =makeup(indicate date of Missed SessionWithin 2 weeks)Indirect ServicesStart Time(immediately following the session)Indirect ServicesEnd Time(immediately following the session)1____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm2____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm3____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm4____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm5____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm6____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm7____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm8____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm9____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm10____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm11____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm12____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm13____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm14____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm15____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm16____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm17____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm18____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm19____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm20____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm21____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm22____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm23____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm24____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm25____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm26____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm27____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm28____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm29____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm30____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pmMonthly Multidisciplinary Meeting Date:___/___/___ Participants: Name/Title:_____________________________________________________________________________ (In narrative form, please describe what was discussed, any issues that have arisen, troubleshooting and problem solving.)Team Recommendations:31____:____am/pm____:____am/pmR / M ____/____/_______:___am/pm___:___am/pm Service Provider’s Signature:___________________________Date:___________ Total Billable Sessions:_______****Session Notes (Originals) Must be Attached and correspond to this Monthly Log-Page 1Page 2-Instructions for Completing Monthly Log-SW-FT:Complete ALL demographic information at the top of the page, including child’s name and ID #, frequency and duration, type of service, and provider’s name and credentials.Next to the corresponding date of Direct service, enter start and end time of the provided session and record whether it is a regular or make-up session (if it is a make-up session, you must provide the date of the missed session and have a corresponding blank session note for it).You must now also include any Indirect time spent on the case. For example, enter the time that you spent writing the session note (which must be after the completion of the session and at least 5 minutes in length). This excludes the travel time. Any time that you have spent on the case for that day EXCLUDING your time spent with the child/parent is considered INDIRECT time. Please note: basic sessions are 30-59 minutes; extended sessions are 60 minutes plus.Sign, date, and indicate the number of billable sessions.Instructions for Completing CPT/ICD-10 Codes on Session Notes_AttachedUse the chart below to indicate the child’s type of delay (ICD-10 codes) (from evaluations) and the type of therapy you have provided (CPT codes)-( (HCPCS codes –as CPT codes are only to be used by licensed clinicians- Please do not place them next to CPT codes on Session Notes)CPT CodeDescriptionICD-9 Code-til 9/30/15ICD-10-effective 10/1/15Unit DefinitionRestrictions90804Individual psychotherapy, insight-oriented, behavior modifying, and/or supportive in an office or outpatient facility315.5 Delay in Development, Mixed299.8 /299.00-Pervasive Developmental Disorder/NOSF82- Specific developmental disorder of motor functionF84.0- Autistic disorder20-30 minutes?90806Individual psychotherapy, insight-oriented, behavior modifying, and/or supportive in an office or outpatient facility315.5 Delay in Development, Mixed299.8/299.0- Pervasive Developmental DisorderSee above codes?45-50 minutes?90808Individual psychotherapy, insight-oriented, behavior modifying, and/or supportive in an office or outpatient facility315.5 Delay in Development, Mixed299.8/299.0- Pervasive Developmental DisorderSee above codes75-80 minutes99510Home visit for individual, family, or marriage counseling315.5 Delay in Development, Mixed299.8 Pervasive Developmental DisorderF81.9- Dev. disorder of scholastic skills, unspecified84.8- Other pervasive dev. disordersEncounter90847Family psychotherapy (with child present)315.5 Delay in Development, Mixed299.8 Pervasive Developmental DisorderSee above codesEncounterHCPCS Code: T1027Family Training or counseling for child development315.5 Delay in Development, Mixed299.8 Pervasive Developmental DisorderSee above codes15 minutes In the event you require more codes please refer to: ................
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