Wiki CPT code 96150 and 96151 only for CSW????

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rcranshaw

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Hello,

I have pain Physicians and NPs performing risk assessments on patients at each visit. I would like to use 96150 and 96151 in conjunction with E/M codes 99201-99204 and 99211-99214. I looked at the MCR LCD for 96150 and 96151. It speaks of a CSW. Does that mean that is the only provider type allowed for that code? Can a Physician or NP perform those services and bill that code also? These codes best describe the assessment. They are using the information given to help determine the patient's pain level. And also basing the medical decision making, and plan off of these assessments. Patients are being asked about their prescription/illegal drug uses, alcohol use, and how medication is used.

Please help!!
 
Hello,

I have pain Physicians and NPs performing risk assessments on patients at each visit. I would like to use 96150 and 96151 in conjunction with E/M codes 99201-99204 and 99211-99214. I looked at the MCR LCD for 96150 and 96151. It speaks of a CSW. Does that mean that is the only provider type allowed for that code? Can a Physician or NP perform those services and bill that code also? These codes best describe the assessment. They are using the information given to help determine the patient's pain level. And also basing the medical decision making, and plan off of these assessments. Patients are being asked about their prescription/illegal drug uses, alcohol use, and how medication is used.
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96150 and 96151 can not be billed under any circumstances with 99201-99204 or 99211-99214.

96150 series Health and behavior assessment (eg, health-focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires), each 15 minutes face-to-face with the patient; initial assessment

The provider, which may include a physician but is typically a nonphysician practitioner, such as a licensed psychologist, performs an assessment of factors that affect the patient’s health, rather than assessing for a specific mental health disorder.

Cheryl Anderson, LPN, CPC, CPC-I, CEMC
 
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