Live Webinar - Sharpen Your Evaluation and Management Coding SkillsRegister Now >>

Regular Price: $24.95

Ask An Expert Starting at $24.95

Have a medical coding or compliance question? Don’t sacrifice your valuable time to endless research. Choose Ask an Expert to get clear answers from the TCI SuperCoder team. And here’s a tip for the budget-conscious: Select the 12-question pack to get the best rate per question!

Browse Past Questions By Specialty

+View all

ref. Reimbursement for concussion screening

Shahid Posted Mon 18th of March, 2019 15:35:22 PM
We are using a new Virtual Reality headset for running concussion screening tests. Which CPT codes can be used to bill for it?
SuperCoder Answered Tue 19th of March, 2019 05:24:33 AM

Thank you for your Question.

The undermentioned CPT codes are effective from Jan 2019 for these type of screening tests:

96136 — Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; first 30 minutes

+96137 — … each additional 30 minutes (List separately in addition to code for primary procedure)

96138 — Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; first 30 minutes

+96139 — … each additional 30 minutes (List separately in addition to code for primary procedure)

96146 — Psychological or neuropsychological test administration, with single automated, standardized instrument via electronic platform, with automated result only.

These codes can be reported for administration and scoring on the same day even when the services are performed on different days. However, as there are time components to 96136-+96139, make sure a separate time spent on evaluation and time spent on administration and scoring services must be documented. This will be especially important when the same provider administers the test and then evaluates it.

For evaluation services e.g.  integration of patient data, interpretation of standardized test results, clinical data, clinical decision making, treatment planning, report & interactive feedback use undermentioned codes:

96132 —Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report and interactive feedback to the patient, family member(s) or caregiver(s), when performed; first hour

+96133 — …Each additional hour (List separately in addition to code for primary procedure)

Hope this Helps!

Shahid Posted Tue 19th of March, 2019 13:13:44 PM
What is the reimbursement for these codes?
SuperCoder Answered Fri 22nd of March, 2019 06:46:11 AM

Reimbursement guidelines for neuropsychological testing varies from state to state and payer to payer. Kindly check with your payer for reimbursement of these codes.

 

Note:

Some insurance companies consider neuropsychological testing a mental health service and as such will only allow for a mental diagnosis when billing.

Most carriers will cover neuropsychological testing for sports and non-sports concussion as long as their respective policies/rules are followed.

Hope this Helps!

Related Topics