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EPDS screening

K

Korbc

Expert
Messages
414
Location
Uncasville , CT
H96ey there!

Does anyone charge separately for this like a 96127? and if not charged separately can i count it towards mdm as test ordered? thanks so much!
 
We bill 96160 with Z13.31 unless there is a finding then we use the appropriate F code for the dx. We administer the screening at initial ob, 24 week and and PP visits and they are covered differently depending on the payer. We do not count for MDM because most of those visits are currently included in the global.
 
thanks! so for a pp deppresion screening without dx of depression or anxiety before their 6 week pp visit would just be the 96160 or 96127. which would be more appropriate for pp period and using the epds score? and just that screening code no e/m with it right unless they had something totally different going on as well like infection or a different chronic cond. addressed etc etc?

thanks!
 
Korbc said:
thanks! so for a pp deppresion screening without dx of depression or anxiety before their 6 week pp visit would just be the 96160 or 96127. which would be more appropriate for pp period and using the epds score? and just that screening code no e/m with it right unless they had something totally different going on as well like infection or a different chronic cond. addressed etc etc?

thanks!
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also which one am i supposed to use for the epds screening? 96160 or 96127?
 
We are just starting to use this screening form for our New OB Patients. I feel like 96161 is the appropriate one for us as we are screening for any maternal related depression. My question is can we bill for this form even though we aren't billing an office visit? We are RHC clinic and we bill global. I think we plan to do this screening at the first visit and at about 28 weeks pregnancy. Anyone know if it matters how many times it is billed? Ty!
** found out 96161 is for pediatrician office; giving mother the assessment during child's visit. TY!**
 
Last edited:
desireewhite185@yahoo.com said:
We are just starting to use this screening form for our New OB Patients. I feel like 96161 is the appropriate one for us as we are screening for any maternal related depression. My question is can we bill for this form even though we aren't billing an office visit? We are RHC clinic and we bill global. I think we plan to do this screening at the first visit and at about 28 weeks pregnancy. Anyone know if it matters how many times it is billed? Ty!
Click to expand...
hey! yea i know why def use this to screen for pp depression at pp visits, and i believe 1st obs. we do mood checks after birth for certain more susceptible people with a history of anxiety and depression and we do this at those apts. I would imagine no office e/m just the screening code itself like how the person above says they do. I hope anyone else who charges for one of these codes chimes in to :)
 
Hello,
My manager feels like the CPT 96161 is for the pediatrician's office to bill when they screen the mother.
Do you think we should use 96127 or 96160? Looks more like 96160 from what I find online. Ty!
 
Last edited:
desireewhite185@yahoo.com said:
Hello,
My manager feels like the CPT 96161 is for the pediatrician's office to bill when they screen the mother.
Do you think we should use 96127 or 96160? Looks more like 96160 from what I find online. Ty!
Click to expand...
96161 is care-giver focused - that is the care-giver is filling out the form so yes, it would be used in a pediatrician's office. For a an assessment of the patient which directly involves the patient answering the questions choices are 96127 or 96160. 96127 is more specific for behavioral and emotional assessment and would cover a depression assessment. 96160 is a more general screen for health in general.
 
Thank you for the response. Sorry I should have asked, we bill globally, but they want this form billed for every OB patient. They are going to give it to them at the beginning of the global and mid-way for screening. Is this appropriate to enter/bill every time? Or should it only be entered when the form is positive for an issue? Ty!
 
desireewhite185@yahoo.com said:
Thank you for the response. Sorry I should have asked, we bill globally, but they want this form billed for every OB patient. They are going to give it to them at the beginning of the global and mid-way for screening. Is this appropriate to enter/bill every time? Or should it only be entered when the form is positive for an issue? Ty!
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You can bill each time you administer it, but payment will be up to the payor. Performing the assessment is not contingent on there being a positive result, only that it was deemed medically indicated to perform it the assessment.
 
Korbc said:
I'm also seeing this is global now unless a formal dx is made from it, does anyone know if this is true?

thanks!
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We use 96160, and I've noticed the majority will get denied if it's coded with 59430 or by itself for a routine ppv that's part of a global, but some also get denied if they are coded with a problem-oriented ppv. I really believe it just depends on the payer's bundling rules.
 
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