Wiki CPT for Depression Screen

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anne32

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I am trying to capture payment for various screenings we do in our family practice, including depression screening, but want to make sure we are billing correctly. We administer a PHQ9 test to our patients at the time of their visit. Would we bill 99420 along w/ an E/M and 25 modifier for the other issues they came in for? Are insurances paying both the E/M and the 99420? What is the difference between 99420 and 96127? When would I use each of these codes? Any help is VERY appreciated!!
 
99420 is for a health risk assessment, which has components of depression screening in it. We use 96127 for the PHQ-9 and GAD-7 screening done in our clinics and we get paid for them almost 100% of the time.
 
How often can this code be used? Our clinic does a depression screening for almost everyone that comes in. Is it used when the come in for there wellness exam?
 
Billin MGR

We bill G0444 with patient's annual physical. We have a lot of difficulty getting it paid. We tried changing up the diagnosis - we used Z00.00 & Z13.89 but it gets denied. Any suggestions?
 
Hello -
we use G0444 and add modifier 25 to it. Hope this helps.
~Stephanie G - CPC with My Dr Now.
 
Can a behavioral health office bill Medicare for G0444 and the other preventive codes such as G0442, G0447? Or, are these codes specifically for a primary care setting? We are looking into these codes and it sounds like it's just for primary care.

Thanks
 
When you are billing G0444 are you doing the full PHQ-9? Or are you just doing the PHQ-2 with a negative results? My understanding is if the first 2 answers don't indicate a need to go further then its bundled in the E&M.
 
We are not billing them yet. But we would be doing the full PHQ-9.

I just read the NCD's for these codes and it says in the "primary care setting".

Thanks,
 
Does anyone know if 99240 can be billed for completing the PHQ9 or does there have to be a low to moderate risk, which would be a score of atleast 5. I'm assuming if the results are negative then it is bundled into the LOS. Also, who needs to review the results in order for it to be billable, would this be able to be completed by the MA or a nurse? Any advice on any of this is much appreciated.

Thank you!
Leah
 
jaimepl63 said:
We bill G0444 with patient's annual physical. We have a lot of difficulty getting it paid. We tried changing up the diagnosis - we used Z00.00 & Z13.89 but it gets denied. Any suggestions?
Click to expand...

G0444 use dx Z13.89 and mod 59 for Medicare. Can be used with OV and/or Physical. Can't be billed with G0402, Welcome to Medicare.
 
CodingKing said:
When you are billing G0444 are you doing the full PHQ-9? Or are you just doing the PHQ-2 with a negative results? My understanding is if the first 2 answers don't indicate a need to go further then its bundled in the E&M.
Click to expand...

CodingKing, can you please direct me where to look for the info you have given? We have an office that has started billing 96127 for PHQ-2 on every patient, every encounter and using Z13.89 "because someone told us we can." I am trying to find clear documentation that if the PHQ-2 is negative, it cannot be billed separately from the E&M. I have spent the day searching CMS, WPS Medicare, our local BCBS...and I'm not finding the info you have shared. I would certainly appreciated any direction you can give me.
 
96127 for Vanderbilt Parent Form

Looking for guidelines in using 96127 for Vanderbilt Parent Form during an ADD follow up appointment. The payer is Peach State and I haven't been able to locate any guidelines for this code with them. Does anyone have any information that could help me?

Thanks,
Lisa
 
kari2007 said:
99420 is for a health risk assessment, which has components of depression screening in it. We use 96127 for the PHQ-9 and GAD-7 screening done in our clinics and we get paid for them almost 100% of the time.
Click to expand...

Can someone please tell me what the documentation requirements are when billing for CPT 96127?
 
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