There still isn't a list of accepted diagnoses for 96020 There is good news surrounding CPT's new-for-2007 code for functional brain mapping. Neurosurgery coders are delighted that the code lets you report the treatment with greater accuracy.
But you must be sure you know how to code each part of the procedure before submitting claims -- or this new code could cause a heap of denials for your practice.
To help guide you through the do's and don-ts of reporting 96020 (Neurofunctional testing selection and administration during noninvasive imaging functional brain mapping, with test administered entirely by a physician or psychologist, with review of test results and report), read this expert advice on how you should use it to correctly report your neurosurgeon's services. Physician Might Perform Mapping Before Surgery Neurosurgeons use functional brain mapping as a noninvasive way to help predict the potential for neurological problems that tumor growths, surgical interventions or other factors might cause. Conducting the test helps the physician and patient make informed decisions concerning surgery or other treatments.
-Preoperative, noninvasive neurofunctional mapping is an alternative to direct cortical stimulation or somatosensory evoked potentials, which may be unsuccessful and be associated with visual distortion, seizure and longer surgical time,- says Neil Busis, MD, clinical associate professor in the University of Pittsburgh School of Medicine's neurology department.
-The functional brain mapping code is too new to see a list of approved diagnoses from the carriers,- adds Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS, CodeRyte Inc. coding analyst and coding review teacher.
Diagnoses that Jandroep and others believe you might see associated with functional brain mapping in the future include:
- arteriovenous malformations -- 747.x (Other congenital anomalies of circulatory system)
- epilepsy -- 345.x (Epilepsy and recurrent seizures)
- traumatic brain injury -- 854.x (Intracranial injury of other and unspecified nature)
- Parkinson's disease -- 332.x
- schizophrenia -- 295.x (Schizophrenic disorders)
- Huntington's disease -- 333.4 (Huntington's chorea). If you-d like more details on possible diagnoses, Jandroep recommends that you check out the Web site
www.neurognostics.com/fMRI_Users_Neurology&Neuropsychology.htm. Read the Fine Print for Better Direction Because 96020 is a new code in a new section, CPT elaborates by including several notes to help you report the code correctly.
The first note is a general explanation of the code and when you will use it -- when your provider selects and administers neurological function tests (or language, memory, movement, etc.) with functional neuroimaging, monitoring the patient's performance and determining the test's validity relative to -separately interpreted functional magnetic resonance images.-
Note: See CPT for the complete explanation.
Other notes beneath 96020's descriptor give more details about correct reporting:
- For functional magnetic resonance imaging (fMRI) of the brain, use 70555 (Magnetic resonance imaging, brain, functional MRI; requiring physician or psychologist administration of entire neurofunctional testing).
- Do not report [...]
