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who can perform 96103

Sherrie Posted Mon 13th of February, 2012 15:38:22 PM

Who can perform 96103? Does the provider need to be of a specific specialty or have special training?

Thank you!

SuperCoder Answered Mon 13th of February, 2012 18:31:34 PM

Hello – 96103 requires interpretation and report by a qualified health care professional: Psychological testing (includes psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, eg, MMPI), administered by a computer, with qualified health care professional interpretation and report

The AMA lists the definition of qualified health care professional as part of the "CPT® 2012 Errata" on its website (www.ama-assn.org/resources/doc/cpt/cpt-corrections.pdf). The definition is as follows:
"A ‘physician or other qualified health care professional’ is an individual who is qualified by education, training, licensure/regulation (when applicable), and facility privileging (when applicable) who performs a professional service within his/her scope of practice and independently reports that professional service. These professionals are distinct from ‘clinical staff.’ A clinical staff member is a person who works under the supervision of a physician or other qualified health care professional and who is allowed by law, regulation and facility policy to perform or assist in the performance of a specified professional service, but who does not individually report that professional service. Other policies may also affect who may report specified services."

The “other policies” could mean state scope of service rules. My understanding is that a psychologist is the most likely (but not required) professional for the code.

Regards,
Deborah Marsh, JD, MA, CPC, CHONC
The Coding Institute

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