Wiki 96101 with an E/M

lgirouard14

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Does anyone happen to know if we are able to bill for a 96101(Psychological testing) in conjunction with an E/M code?
Thank you!
 
That would generally depend on the patient's insurance carrier. However, in terms of Correct Coding, my CCI validation tool explains that you would need to at least append a modifier 25 to the E/M code. If documentation supports the Psych test and medical necessity also supports a Significantly, Separately problem in the shape of an E/M, then you might be able to bill both.

Also, the provider would be able to bill either visit independent of each other, meaning a regular psychologist could not do 96101 and an E/M visit, unless the state the provider is practicing in allows otherwise.
 
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