MMPI session question

[deleted106747]

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I don’t do a lot of testing and a question came up today that I couldn’t answer and can’t find any research on. For people with low tolerance, what is the maximum number of sessions that it would be sound to administer it across?

 

[WisNeuro]

I've had people work on it on and off within the context of a larger evaluation. I've only had to have a person come back to complete it another day once.

 

[PsyDr]

I’m guessing the manual says one session. And I’m guessing that multiple sessions would just destroy VRIN.

 

[AbnormalPsych]

Not sure. Haven't read the manual in a couple years but I'm sure it is 1 session/day. I have done this 2-3x when things came up outside of my control. Invited them back the next day to complete. Interpret with extreme caution with note of this deviation clearly in the report. Pt made aware of the issues and still wanted to proceed.

 

[Justanothergrad]

I've not seen a lot of populations that cant do 30 minutes of work where a test like this would be appropriate. The loss of validity and standardization seems to outweigh any potential benefit.

 

[erg923]

Read the questions to the patient?

 

[WisNeuro]

Read the questions to the patient?

This is extremely tedious. Also, depending on insurance, they may not pay for it, or make you resubmit your auths several times to eventually get reimbursed when the time you bill doesn't match up with the tests. There are audio recordings of each question.

 

[erg923]

This is extremely tedious. Also, depending on insurance, they may not pay for it, or make you resubmit your auths several times to eventually get reimbursed when the time you bill doesn't match up with the tests. There are audio recordings of each question.

If you are seemingly that desperate for the information, this would seem like the way to go vs forcing a patient to come back to your office several times and have extremely compromised validity.

 

[BuckeyeLove]

Sitting in the room with that CD is also excruciating. Also, are you doing the OG or RF? Cuz that can cut down on time.

 

[WisNeuro]

If you are seemingly that desperate for the information, this would seem like the way to go vs forcing a patient to come back to your office several times and have extremely compromised validity.

I only use it like 10% of the time clinically, and generally speaking, time spent administering questionnaires is not billable. I'm never that desperate for that particular information clinically. And if I'm doing it forensically, I get to bill that time spent at a decent clip. As for validity, theoretically, it shoudl not matter if they come back another day to finish it. It's supposedly a measure of trait, rather than state characteristics. Chances are, if they'd invalidate it due to two separate sessions, they'd invalidate it at a very similar incidence in one contiguous session in most circumstances.

I'd never do it forensically, because the opposing counsel is likely looking for any meaningless break from standardized administration to throw the results out.

 

[WisNeuro]

As a side note, the MMPI manual administration advises against reading the items aloud, so if you're going to use an alternative strategy at question delivery in any thing that could be slightly legal, go with the audio recordings.

 

[AcronymAllergy]

I only use it like 10% of the time clinically, and generally speaking, time spent administering questionnaires is not billable. I'm never that desperate for that particular information clinically. And if I'm doing it forensically, I get to bill that time spent at a decent clip. As for validity, theoretically, it shoudl not matter if they come back another day to finish it. It's supposedly a measure of trait, rather than state characteristics. Chances are, if they'd invalidate it due to two separate sessions, they'd invalidate it at a very similar incidence in one contiguous session in most circumstances.

I'd never do it forensically, because the opposing counsel is likely looking for any meaningless break from standardized administration to throw the results out.

As a slight aside, my understanding was that it can be billable if you're actually in the room with them while they're doing it. But I'm in the VA bubble.

To return to the OP's question, I honestly don't know, and I don't have a manual right in front of me to check. I don't know if the authors even thought of how many sessions it could be spread across before it was potentially invalidated. Me personally, I'd be very hesitant to spread it out across more than two sessions tops, and even then only in rare and extenuating circumstances.

 

[WisNeuro]

As a slight aside, my understanding was that it can be billable if you're actually in the room with them while they're doing it. But I'm in the VA bubble.

To return to the OP's question, I honestly don't know, and I don't have a manual right in front of me to check. I don't know if the authors even thought of how many sessions it could be spread across before it was potentially invalidated. Me personally, I'd be very hesitant to spread it out across more than two sessions tops, and even then only in rare and extenuating circumstances.

The wording in CMS can be vague, but in general, they state that you cannot bill for time that the patient is filling out questionnaires. Some insurances view this pretty rigidly, others, not as much. If you're doing your job correctly, you'd note that you administered the MMPI 2/RF using audio or whatever, and say BCBS, would jump on that and say that they are not going to cover X units of 96137 or comparable tech code.

 

[erg923]

As a slight aside, my understanding was that it can be billable if you're actually in the room with them while they're doing it. But I'm in the VA bubble.

To return to the OP's question, I honestly don't know, and I don't have a manual right in front of me to check. I don't know if the authors even thought of how many sessions it could be spread across before it was potentially invalidated. Me personally, I'd be very hesitant to spread it out across more than two sessions tops, and even then only in rare and extenuating circumstances.

Its to prevent duplicate billing or for a labor you arent doing. You of course shouldn't be billing administration time if you aren't administering anything. Your physical proximity to the patient has nothing to do with it.

 

[WisNeuro]

Its to prevent duplicate billing or for a labor you arent doing. You of course shouldn't be billing administration time if you aren't administering anything. Your physical proximity to the patient has nothing to do with it.

I believe that people are arguing for the rare instance where you need to be more hands on for helping them fill out questionnaires. You can indeed bill for things such as the time spent explaining the questionnaire. But, if you do something non-standardized, such as read the MMPI or other instrument questions aloud, some could argue that you are still administering something. It happens so rarely for me that I don't bill that extra time as I don't want the potential hassle. But, CMS guidelines are not clear on those rare circumstances.

 

[AcronymAllergy]

Makes sense, thanks for the clarification.

 

[WisNeuro]

If the patient is blind, do you not administer personality testing?

If they can read braille, I believe Pearson has that available, otherwise, use the audio recordings. Hasn't come up for me yet.

 

[R. Matey]

Thanks, I deleted the post because I just saw what you said about audio recordings. Makes sense to use braille too.

 

[deleted106747]

Thanks for the feedback. I got into the office today and reunited with my manual, which states that administration across sessions is okay.

 

[msc545]

Thanks for the feedback. I got into the office today and reunited with my manual, which states that administration across sessions is okay.

Does it say how many sessions ? I can't find my manual.

 

[Justanothergrad]

Does it say how many sessions ? I can't find my manual.

MMPI-2-RF doesn't include this recommendation as I recall (and I suspect the MMPI-3 won't, but haven't seen)

MMPI-2 is more flexible in general with standardization and even includes group administration recommendations for up to 25. It notes that you can take it "over several shorter sessions over a limited period time, say before and after an interruption for routine procedures" (p. 9). I doubt they intended it for multiple days based on this, or on my speculation based on those I know in the MMPI and their perspectives of test-retest reliability.