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Psychological Testing/Administration Base and Addon Codes

Justin Posted Tue 30th of June, 2020 20:01:00 PM
For psychological/neuropsychological testing codes 96130/96132 - these codes are used for the first hour of service. For each subsequent additional hour, you use 96131/96133 respectively. The question we have is that when these services take place over the course of several days - for example testing, do we use both the primary and add-on code for each instance/date of service or do we only use the primary code once and all subsequent days use the add-on code, even for days where the primary code wouldn't be listed as it wasn't the initial service. Also 96130/96132 and 96136 are codes used this way for multiple services (ie - 96130 is for integration of patient data; treatment planning; interactive feedback to the client) - are these all considered the same service across multiple days, or are these separate? As an example: say integration of patient data was on Monday for the first instance of service, which is 96130 for the first hour, then on Tuesday there was work done on treatment planning for an hour - is that coded as solely the addon code of 96131 because it's past the first instance of 96130? Or is it different because they're different service activities of the same code?
SuperCoder Answered Wed 01st of July, 2020 06:44:55 AM

Hi,

Thanks for your question,

Psychologists or neuropsychologists provide testing evaluation services 96130-96133 and Test Administration and Scoring services 96136-96139 across multiple DOS. The sessions may include multiple scoring testing, non face to face time for professional services and interactive feedback.

It is recommended that when services are spread out over multiple visits, then all codes be billed together on last DOS when evaluation process is completed. Also, a base  code should only be submitted for the first unit of service of the evaluation process, and only add-on codes be used to capture the services provided during subsequent days of service.

If a practice or payer requires that a bill be submitted prior to completion of the entire evaluation process, then it is recommended that a note be submitted on the date of each service that indicates the number of hours of service provided and billed on that day “with evaluation ongoing and report to follow”. Final report documentation should include all dates billed corresponding to services provided.

Hope this helps.

Thanks.

 

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