What is the reason these services are being performed. It appears based on your listing the WISC5 & WJ4 tests that this IQ testing or psychoeducational testing in nature. Also, you indicated that there are 6 different activities that are going to be performed for 30 minutes each which only total 3 hours of testing:
- clinical review= 30 minutes
- mental exam= 30 minutes
- personality measures= 30 minutes
- projective measures= 30 minutes
- WISC5= 30 minutes
- WJ4= 30 minutes
However, your coding is for a total 6.5 hours based on the following codes and units listed in the first line of your post.
- 961310x 1= 1 hour
- 96131 x 4= 4 hours
- 96136 x 1= 30 minutes
- 96137 x 2= 1 hour
Your post prompts so many questions for me as an auditor for a commercial insurance company. From my perspective if I got this claim or prior authorization request (most commercial insurance companies require a PA for these services), I would question whether there is a covered medical or behavioral health diagnosis and how much actual time was spent on this testing since your coding is for 6.5 hours, but your narrative only reflects 3 hours of testing. This would very likely be denied as a claim or a PA request.