Wiki 96150

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Maryst

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Could someone please advise me to where I can find more information on this code other than the CPT book. Would this code be used for some on with ADD, Bipolar disorder, etc. Are these codes only for use by psychologists or can physicians use it also?
 
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Guidelines for health and behavior assessment

"Health and behavior assessment procedures are used to identify the psychological, behavioral, emotional, cognitive, and social factors important to the prevention, treatment, or management of physical health problems. The focus of the assessment is not on mental health but on the biopsychosocial factors important to physical health problems and treatments.

Health and behavior intervention procedures are used to modify the psychological, behavioral, emotional, cognitive, and social factors identified as important to or directly affecting the patient's physiological functioning, disease status, health, and well being. The focus of the intervention is to improve the patient's health and well being utilizing cognitive, behavioral, social, and/or psychophysiological procedures designed to ameliorate specific disease- related problems.

Codes 96150-96155 describe services associated with an acute or chronic illness (not meeting criteria for psychiatric diagnosis), prevention of a physical illness or disability, and maintenance of health, not meeting criteria for a psychiatric diagnosis, or representing a preventive medicine service.

For patients that require psychiatric services (90801- 90899) as well as health and behavior assessment/ intervention (96150-96155), report the predominant service performed. Do not report codes 96150-96155 in addition to codes 90801-90899 on the same date.

E&M codes should not be reported on the same day."
CPT Assistant, March 2002

CPT assistants can be a very useful resource, additional information related to these codes may also be found in the following issues:
Feb 2004
Mar 2004
May 2005
June 2005

I hope this helps,
 
Thanks Anthony. I have found all of that information but I have a physician asking when would this code be used by a physician or if it could even be used? Could you give an example of when this code would be used? The guidelinestates "Not on mental health but on the biopsychosocial factors important to physical health problems and treatment"?
 
Did you ever get follow up on this?:

Our neurologist is claiming that he can bill for this and be paid, but so far we have not yet had one insurance pay for this procedure. In the light that it is not to be used with EM codes, how on earth CAN we get this paid, and as a novice coder, I'm trying to determine which is the best way to approach this!

Suzanne E. Byrum CPC-A, Everett, WA

Sharae said:
Thanks Anthony. I have found all of that information but I have a physician asking when would this code be used by a physician or if it could even be used? Could you give an example of when this code would be used? The guidelinestates "Not on mental health but on the biopsychosocial factors important to physical health problems and treatment"?
Click to expand...
 
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