Pediatric Coding Alert

Question: We recently started performing baseline impact testing for concussions. Which diagnosis code should we use for this service? We are leaning toward 850.9 but aren't sure.

Kentucky Subscriber

Answer: The answer depends on whether the patient has a current concussion or whether you're performing a screening test. If the patient has a concussion, you'll report the appropriate diagnosis code such as 850.9 (Concussion unspecified) as you mentioned. In addition, you'll report 96120 (Neuropsychological testing [eg, Wisconsin Card Sorting Test], administered by a computer, with qualified health care professional interpretation and report) for the impact test.

If, however, you're performing a baseline screening test on a patient with no injury, trauma or concussion, the rules are different. In many cases, pediatricians perform these tests to maintain as a baseline, so if the patient ever suffers a head injury you can compare the two tests. In these cases, most insurers do not pay for the screening.

If you've performed a non-payable screening test but you still want to report a diagnosis code, look to the appropriate V code such as V82.9 (Screening for unspecified condition).