Wiki How do you code for the Pediatric Symptom Checklist done in the office? 96127? 96110?

gklos2

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I am new to coding and trying to learn more everyday. But today I am stumped. I have providers billing the Pediatric Symptom Checklist different ways and I am torn between the two codes.

96110 - Developmental screening (eg, developmental milestone survey, speech and language delay screen), with scoring and documentation, per standardized instrument
96127 - Brief emotional/behavioral assessment (eg, depression inventory, attention-deficit/hyperactivity disorder [ADHD] scale), with scoring and documentation, per standardized instrument

I've looked at the Medicaid appendices and it is listed under both codes. I personally see 96127 as the correct code but then when I look at different sources they are saying to bill the PSC test as 96110. I am torn, because 96127 sounds more appropriate to what they are testing but certain sources are saying to code 96110, like the American Academy of Pediatrics. If anyone has any insight it would be greatly appreciated so my mind stops playing pong (going back and forth between the two codes).
 
In searching it seems the AAP has a little contradiction. I found an older article 2005 that stated 96110; however all of the newer articles that I have found state to use the 96127. I agree with you, the 96127 sounds more appropriate and would go with the newer information.
 
I am new to family practice and receiving repeated denials from Wellcare Medicaid for the 96127 and 96110 indicating screening guidelines not met. Does anyone have any advice to help with this. The diagnosis code used is Z00.129.
 
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