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96160 - scoring

B

Bchase11

Contributor
Messages
12
Location
Cape Coral, Florida
Good day AAPC Members! I work for a Pediatric practice and we would like to utilize code 96160 and use a scoring sheet. Does anyone have any experience with this code and it's payers, particularly Medicaid? What sheet do you use for scoring? TIA!
 
We do bill 96160 as long as there is some sort of intervention documented and done by the provider, if it is just completed by the patient and there is no a score of 0 and no intervention is needed, then that is bundled into the E/M. But when we do bill it, Medicaid and the Managed Care Medicaid plans usually just bundle this in with the E/M and we do not get paid on it.

Thanks!
 
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