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What to bill?

  1. #1
    Default What to bill?
    Medical Coding Books
    If a 5 year old patient comes in for psych testing to determine if he had ADD/ADHD and the following occrus, what do I bill?

    Patient comes in and takes the CPT test on computer. Dr walks him through what to do, explains and shows him how to do it on the 2 min practise test, and then sits in the room quietly just to keep an eye on him while he takes the test. Dr does not talk to him, does not coach. Simply sits there since a child can't be left unattended.

    What do I bill for the testing? 96101 or 96103?

  2. #2
    Louisville, KY
    96103 seems most appropriate.

    However, this situation begs the question, with supervision of the child required, can we use that time in our total time and report 96101?

    My primary problem with reporting 96101 is that the "intent" of the code is to capture exams that require administration--as opposed to those computer-based. CPT Assistant seems to touch on this briefly in the November, 2006 issue. Based on language from it and the fact that your provider did not interact beyond the basic "practice test", I'd say the safe bet is 96103.

    I hope this helps.

  3. #3
    Thank you so much for your fast response.

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