Wiki How to Bill Psych Test Codes 96101, 96118 and 96116

[tamstrnd]

Can anyone tell me how to bill for these psych test codes when you have a date and time for the actual testing and scoring along with the dates and times for interpreting and preparing the report. All together showing the dates and times under the appropriate code? That would make the most sense as it would tie into the documentation.

Any help or guidance would be much appreciated!

Have a great day!

 

[sparkles1077]

Here are guidelines from Supercoder (I have also seen this with WPS Medicare and Noridian)

The minimum time you need for reporting one unit of 96101 or 96102 is 31 minutes. If the time spent is 30 minutes or less, you cannot report these codes as CPT? time guidelines for these codes have not been met.

Usually, the tests will take five-seven hours for administration, analysis and interpretations. If the testing extends beyond eight hours, a copy of the test reports might need to be sent to determine if extended testing was medically necessary.

If the tests have been performed over several days or if the test was performed on one day and interpretations were provided on another day, the total time spent is added up to calculate the number of units of 96101 or 96102. The last date when testing was done last should be date on the claim form.
For tests administered through the computer, you can report only one unit of 96103 regardless of the number of tests the patient has been administered or the time involved.

 

[hananlabib]

neuro biller

I worked for neurology practice we have cans test as new test we bill 96103 and 96120 it is denied by horizon bcbs for auth ,does any one has another range of codes that can be billed for this test does not need auth
thanks