Neurology & Pain Management Coding Alert

Question: My neuropsychologist says we should code memory loss as 310.1 for Medicare patients and 780.93 for other carriers when our physician conducts neuropsychological testing. Is reporting different diagnoses for different carriers acceptable?

Oregon Subscriber Answer: Submitting 310.1 (Personality change due to conditions classified elsewhere) might fit the situation, but also consider 780.93 (Memory loss) or new code 331.83 (Mild cognitive impairment, so stated). Base your diagnosis on the physician's documentation; if the diagnosis is not on the carrier's approval list, have the patient sign an advance beneficiary notice (ABN) stating her responsibility for payment.

CPT also gives you two code choices when you report the test itself:

- 96118 -- Neuropsychological testing (e.g., Halstead-Reitan Neuropsychological Battery, Wechsler Memory Scales and Wisconsin Card Sorting Test), per hour of the psychologist's or physician's time, both face-to-face time with the patient and time interpreting test results and preparing the report

- 96119 -- Neuropsychological testing (e.g., Halstead-Reitan Neuropsychological Battery, Wechsler Memory Scales and Wisconsin Card Sorting Test), with qualified healthcare professional interpretation and report, administered by technician, per hour of technician time, face-to-face. Report 96118 when your physician conducts the test, interpretation and report; report 96119 when a technician conducts the test.