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Kelly Posted Wed 24th of January, 2018 08:57:52 AM
In order to charge CPT 96127 (Brief emotional/behavioral assessment (eg, depression inventory, attention-deficit/hyperactivity disorder [ADHD] scale), with scoring and documentation, per standardized instrument), can the date of the interpretation differ from the date of service? Please site CMS guidelines as a reference. Thanks!
SuperCoder Answered Thu 25th of January, 2018 08:23:53 AM

Hi Kelly,

Cpt code 96127 includes administration of the instrument as well its scoring and documentation. However, you can report 96127 if your clinician is performing interpretations of an assessment that was administered by another individual such as a teacher or a parent of the person who is being assessed. So, it is not necessary that your clinician should be the one who administers the assessment. Since the code descriptor explicitly references scoring and documenting the result, be cautious about reporting 96127 if the physician or someone else in the practice does not provide that part of the service.At a minimum, the physician reporting the service should be the one who is interpreting the results of the assessment in order for you to report 96127.

https://www.supercoder.com/coding-newsletters/my-psychiatry-coding-alert/reader-question-know-if-96127-can-be-reported-only-for-interpretations-149514-article

 

Hope this helps!

Kelly Posted Thu 25th of January, 2018 10:30:05 AM
My question was specifically about the dates of service verses the date of the interpretation... In order to charge CPT 96127..., "can the date of the interpretation differ from the date of service"? Please site CMS guidelines as a reference.
SuperCoder Answered Tue 30th of January, 2018 10:31:19 AM

The appropriate date of service for CPT® code 96127; Brief emotional/behavioral assessment (eg, depression inventory, attention-deficit/hyperactivity disorder [ADHD] scale), with scoring and documentation, per standardized instrument will be the date that the service was completed.  Unfortunately, there are no specific CMS guidelines for this code. CPT® code 96127 is similar to one of the categories “Psychiatric Testing and Evaluations” which states that “the date of service should be reported on the claim as the date on which the service (based on CPT® code description) concluded”.  Since this code includes scoring and documentation of the test, you would need to report the date that this service concluded, which would be the date that the provider scored and interpreted the test.  Please see the attached CMS document outlining date of service billing guidelines for specific circumstances.

 

>https://www.novitas-solutions.com/webcenter/portal/MedicareJH/page/pagebyid?contentId=00158101&_afrLoop=506439902445324#!@@?_afrLoop=506439902445324&contentId=00158101&_adf.ctrl-state=t8odrdiii_34

 

>https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c15.pdf

 

Kelly Posted Tue 30th of January, 2018 13:35:17 PM
Perfect! Just what I needed! Thank you!
SuperCoder Answered Wed 31st of January, 2018 04:57:07 AM

Happy to Help!

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