Bonnie Posted Mon 07th of January, 2013 16:58:34 PM
I am being told by BC/BS that cpt 96110 can only be billed
once per visit as of 2012. Can you please tell if such
a change in billing has occurred.
SuperCoder Answered Mon 07th of January, 2013 20:49:06 PM
It's possible that an individual Blue Cross/Blue Shield payer has adapted this rule, but there is no across-the-board rule limiting you to one instance of 96110 per day. I have heard of 96111 being allowable only once a day (http://www.medicalhomeinfo.org/downloads/pdfs/DevelopmentalScreening-TestingCodingFactSheet.pdf) but not 96110.
In fact, one Medicaid provider has a "frequently asked questions" page about this code (http://www.ok.gov/health/Child_and_Family_Health/Child_Guidance_Service/Developmental_Screening_Information/Frequently_Asked_Questions/index.html), which states: "QUESTION: Can I bill for 96110 more than once in a day (for example, if I have a parent complete an ASQ and an M-CHAT at the 18 month visit)?
· Yes, in this example, a professional could bill for 2 instances of 96110."
Torrey Kim, CPC, CGSC
Pediatric Coding Alert