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Wiki Can you bill 99392-25 with 96110-59?
- Thread starter kmshea321
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smartcoder
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it not payer specific. you need only modifier on the e/m code. 96110 is age specific.
Can you bill a 96110 for a elderly mini mental exam ?
Here's the full description for 96110:
The provider uses a standardized form to analyze the presence of any developmental disorder, typically during infancy or adolescence, any delay in a child’s developmental milestones, and age appropriate maturity of speech and language, using the measurable parameters of the standardized instrument.
The provider may use the form to determine whether the patient requires any additional work up for the developmental disorder. The provider can use various standardized screening instruments such as the Ages and Stages Questionnaire: Social Emotional, ASQ SE; Australian Scale for Asperger's Syndrome, ASAS; Behavior Assessment Scale for Children, BASC; Behavioral Rating Inventory of Executive Functioning, BRIEF, for Psychological Assessment; Child Development Review; Communication and Symbolic Scales Developmental Profile, CSBS DP; Kaufman Brief Intelligence Test; Parents' Evaluation of Developmental Status, PEDS; Pediatric Symptom Checklist, PSC; and Vanderbilt Rating Scales. The provider then scores and documents the objective data of the findings he detects of any developmental or speech and language delay using an appropriate standardized instrument.
I don't see how this could apply to an elderly mini mental exam. The guidelines at the beginning of the section for 96110 state (my emphasis added)
Section Specific Guideline
The following codes are used to report the services provided during testing of the central nervous system functions. The central nervous system assessments include, but are not limited to, memory, language, visual motor responses, and abstract reasoning/problem-solving abilities. It is accomplished by the combination of several types of testing procedures. Testing procedures include assessment of aphasia and cognitive performance testing, developmental screening and behavioral assessments and testing, and psychological/neuropsychological testing. The administration of these tests will generate material that will be formulated into a report or an automated result.
(For development of cognitive skills, see 97129, 97533)
(For dementia screens, [eg, Folstein Mini-Mental State Examination, by a physician or other qualified health care professional], see Evaluation and Management services codes)
(Do not report assessment of aphasia and cognitive performance testing services [96105, 96125], developmental/behavioral screening and testing services [96110, 96112, 96113, 96127], and psychological/neuropsychological testing services [96116, 96121, 96130, 96131, 96132, 96133, 96136, 96137, 96138, 96139, 96146] in conjunction with 97151, 97152, 97153, 97154, 97155, 97156, 97157, 97158, 0362T, 0373T)
There is a code for a comprehensive cognitive exam, 99483. I doubt a "mini" anything meets the requirements to bill 99483. The guidelines for 99483 state (again, my emphasis added):
Range Specific Guideline
Cognitive assessment and care plan services are provided when a comprehensive evaluation of a new or existing patient, who exhibits signs and/or symptoms of cognitive impairment, is required to establish or confirm a diagnosis, etiology and severity for the condition. This service includes a thorough evaluation of medical and psychosocial factors, potentially contributing to increased morbidity. Do not report cognitive assessment and care plan services if any of the required elements are not performed or are deemed unnecessary for the patient's condition. For these services, see the appropriate evaluation and management code. A single physician or other qualified health care professional should not report 99483 more than once every 180 days.
Services for cognitive assessment and care plan include a cognition-relevant history, as well as an assessment of factors that could be contributing to cognitive impairment, including, but not limited to, psychoactive medication, chronic pain syndromes, infection, depression and other brain disease (eg, tumor, stroke, normal pressure hydrocephalus). Medical decision making includes current and likely progression of the disease, assessing the need for referral for rehabilitative, social, legal, financial, or community-based services, meal, transportation, and other personal assistance services.
While my practice does not perform these types of screens/exams, I am interpreting these guidelines to state that a mini mental exam would be included in the E/M 99202-99215.
The provider uses a standardized form to analyze the presence of any developmental disorder, typically during infancy or adolescence, any delay in a child’s developmental milestones, and age appropriate maturity of speech and language, using the measurable parameters of the standardized instrument.
The provider may use the form to determine whether the patient requires any additional work up for the developmental disorder. The provider can use various standardized screening instruments such as the Ages and Stages Questionnaire: Social Emotional, ASQ SE; Australian Scale for Asperger's Syndrome, ASAS; Behavior Assessment Scale for Children, BASC; Behavioral Rating Inventory of Executive Functioning, BRIEF, for Psychological Assessment; Child Development Review; Communication and Symbolic Scales Developmental Profile, CSBS DP; Kaufman Brief Intelligence Test; Parents' Evaluation of Developmental Status, PEDS; Pediatric Symptom Checklist, PSC; and Vanderbilt Rating Scales. The provider then scores and documents the objective data of the findings he detects of any developmental or speech and language delay using an appropriate standardized instrument.
I don't see how this could apply to an elderly mini mental exam. The guidelines at the beginning of the section for 96110 state (my emphasis added)
Section Specific Guideline
The following codes are used to report the services provided during testing of the central nervous system functions. The central nervous system assessments include, but are not limited to, memory, language, visual motor responses, and abstract reasoning/problem-solving abilities. It is accomplished by the combination of several types of testing procedures. Testing procedures include assessment of aphasia and cognitive performance testing, developmental screening and behavioral assessments and testing, and psychological/neuropsychological testing. The administration of these tests will generate material that will be formulated into a report or an automated result.
(For development of cognitive skills, see 97129, 97533)
(For dementia screens, [eg, Folstein Mini-Mental State Examination, by a physician or other qualified health care professional], see Evaluation and Management services codes)
(Do not report assessment of aphasia and cognitive performance testing services [96105, 96125], developmental/behavioral screening and testing services [96110, 96112, 96113, 96127], and psychological/neuropsychological testing services [96116, 96121, 96130, 96131, 96132, 96133, 96136, 96137, 96138, 96139, 96146] in conjunction with 97151, 97152, 97153, 97154, 97155, 97156, 97157, 97158, 0362T, 0373T)
There is a code for a comprehensive cognitive exam, 99483. I doubt a "mini" anything meets the requirements to bill 99483. The guidelines for 99483 state (again, my emphasis added):
Range Specific Guideline
Cognitive assessment and care plan services are provided when a comprehensive evaluation of a new or existing patient, who exhibits signs and/or symptoms of cognitive impairment, is required to establish or confirm a diagnosis, etiology and severity for the condition. This service includes a thorough evaluation of medical and psychosocial factors, potentially contributing to increased morbidity. Do not report cognitive assessment and care plan services if any of the required elements are not performed or are deemed unnecessary for the patient's condition. For these services, see the appropriate evaluation and management code. A single physician or other qualified health care professional should not report 99483 more than once every 180 days.
Services for cognitive assessment and care plan include a cognition-relevant history, as well as an assessment of factors that could be contributing to cognitive impairment, including, but not limited to, psychoactive medication, chronic pain syndromes, infection, depression and other brain disease (eg, tumor, stroke, normal pressure hydrocephalus). Medical decision making includes current and likely progression of the disease, assessing the need for referral for rehabilitative, social, legal, financial, or community-based services, meal, transportation, and other personal assistance services.
While my practice does not perform these types of screens/exams, I am interpreting these guidelines to state that a mini mental exam would be included in the E/M 99202-99215.
lemorris
Networker
Where do you find "age specific" guidelines? The code description does not mention any age specifications.