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96040

Linda Posted Thu 25th of December, 2014 23:41:40 PM

Gentic Counseling using 96040 is anyone paying this code or are most practices using EM levels for billing using incident to billing?

SuperCoder Answered Fri 26th of December, 2014 02:44:41 AM

You should report 96040 (Medical genetics and genetic counseling services, each 30 minutes face-toface with patient/family) only for a trained genetic counselor’s services. (Currently, the American Board of Genetic Counselors [ABMG] certifies genetic counselors in the US and Canada.) Don’t use 96040 for genetic counseling by a physician or nonphysician who is not a genetic counselor. Although nothing precludes a physician from also being a genetic counselor, CPT states that if a physician provides genetic counseling to an individual, choose the appropriate E/M code. If the physician counsels a patient without symptoms or an established disease, CPT points you instead to 99401-99402 (Preventive medicine counseling …). Before reporting 96040, you also should watch for services such as “obtaining a structured family genetic history, pedigree construction, analysis for genetic risk assessment, and counseling of the patient and family,” CPT states. The counselor may provide the services during one or more sessions and may review medical data and family information, conduct face-to-face interviews, and provide counseling. Report 1 unit for each 30 minutes of documented service.

Thanks !!

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