Wiki Denials for Developmental Screening (96110) when billed with Well Child Check

[cedwards]

I am seeing CPT code 96110 deny when billed with a well child check.
Anyone else experience this? If so with which payers? Do you have anything that you use to successfully appeal the denials?

Thanks!
Christina

 

[Peter Davidyock]

Thanks for posting this Christina,
It's very timely for me. I have a peds clinic that is gearing up to begin billing these for administering a lot of different developmental screenings during preventive visits.

The first question I have is does the screening match the visit/age of the child? Bright Futures (AAP) has a great bulleted spreadsheet outlining the what's and whens. Here is a link:
http://brightfutures.aap.org/index.html

My second question is what was the reason for the denial?

I would appreciate it if you let me know how this resolves.

 

[dfronsoe]

96110

We use modifier 59 with the screening and we use the screening code, i.e., V79.3 for the MCHAT. I hope this helps.