I have a physician who specializes in pain management. He wants to do computerized psychological testing and bill '96103'. Would he be considered a "qualified health care professional" or does the provider need to be a behavior health specialist?
Thank you
Sherrie
FROM CPT ASSISTANT:
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Code 96103, Psychological testing (includes psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, eg, MMPI), administered by a computer, with qualified health care professional interpretation and report, includes interpretation and report by the physician, psychologist, or other qualified health care professional. The computerized testing code 96103 is not a time-based code and is used once per session regardless of the number of test instruments used.
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Clinical Example: 96103
A 35-year-old woman is referred by her primary care physician due to significant changes in behavior. A series of tests (standardized and/or projective) is administered to evaluate emotionality, intellectual abilities, personality, and psychopathology. The administration of the tests is completed by a computer but is overseen by the qualified health care professional.
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Description of Procedure (96103)
The qualified health care professional has met previously with the patient and conducted an interview. On the basis of the information gathered from the interview, the professional has selected test instruments that may be administered by a computer.
The qualified health care professional installs the computer program or test and instructs the patient on the use of the test. The qualified health professional frequently checks the patient to ensure that he or she is completing the test correctly. The professional installs the next instrument and continues as before until all tests are completed.
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The qualified health care professional meets again with the patient in order to answer any final questions about the procedures and to inform him or her about the timetable for the results.
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Coding Tip
Codes 96101-96103 include interpretation and report by the physician, psychologist, or other qualified health care professional. All three codes can be reported on one patient as part of one assessment.
