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Neuropsychological Testing - Help

  1. Default Neuropsychological Testing - Help
    Medical Coding Books
    We have a Psychologist that just joined our group and is going to do a lot of Neuropsych testing. How do I find out which code these tests fall under and how to bill for these certain tests - How many units? How do I know whether to bill a 96101 or a 96118? Is it by the hour face to face and by the time taken to score and write a report?

    Also, If someone takes a test on a Tuesday and the doctor doesn't interprete, score and write the report until Thursday, do we bill all of it together at the end of it? or split the billing in the two different days that they were done?

    Thank you so much for your help on where to start with this.

    Tests examples are:

    Agitation Assessment Scale
    Apathy Assessment Scale
    Beck Depression Inventory
    Beck Anxiety Inventory
    Boston Naming test
    Boston Diagnostic Aphasia Screening Test
    Category Booklet Test
    California Verbal Learning Test II
    Cognitive Estimation Test
    Conners Rating Scale
    Functional Activities Questionnaire
    Geriatric Depression Scale
    Mattis Dementia Rating Scale-2
    Mental State Exam
    Modified Neuropsychological screening Tool
    Minnesota Multiphasic Personality Inventory -2
    Neuropsychological Assessment Battery
    Personality Assessment Inventory
    Psychiatric Rating Scale
    Repeat Battery for the Assessment of Neuropsychological StatusWechsler Test of Adult Reading

    Thank you for your help.

  2. #2
    Hi Melanie
    I just got back from vaca and noticed your post.
    I have never billed the 96118 but have billed the 96101 and we usually bill that after the Dr has finished his time with the patient or report. The test can be lengthy so This code states face to face and also time interpreting those test.
    Regarding units so far I have found it depends on the ins on how many units they will accept. We do about 10 units with this code. So for example he does some face to face testing on day one and then does the interpreting of those test another day we usually bundle up the hours because that is what the code states per hour. So when he reaches an hour we bill the code if he does more than one hour we bill for more units. We try to get the bills out daily so if he is only spending 30 minutes day one that bill would be held until he reaches an hour another day and then billed. If he reaches 2 hours in one day that bill will go out with 2 units that day. Does that make sense?
    The 96101 states Psychological Testing
    The 96118 states Neuropsychological Testing

    Hope that helps in some way.
    MonaLisa CPC
    MonaLisa LaBonte CPC

  3. Default
    If the Psychologist is performing the testing then you would bill 96118 for Neuro-psychological testing...if it was just a Psychological testing then the 96101 would be appropriate.

    The units are Per Hour...these codes are for face to face and the time it takes to score/interpret/write the report. We bill out 1 time once the report has been compelted with the originally DOS that the patient was tested on. You cannot round up units unless it is over .5 of an hour; so 2.5 would go out as 2 units, but 2.55 or over would be 3 units.

  4. #4
    Jacksonville River City FL
    We usually bill 96118 when the patient has a medical condition that may be causing neurological deficits, such as seizures, illness requiring chemo or radiation, etc. We do not bill each test individually; the entire testing is billed according to the reason - 96118/96119 for neuro-psych, 96101/96102 for psycho-educational.

  5. #5
    The neuropsych code 96118 does not include the psychologist reviewing the results with the patient. What would you suggest for coding that visit which can typically last 1to 1-1/2 hrs and may also have family members present?

  6. #6
    Jacksonville River City FL
    We use 90804, 90806, or 90846 - determined by whether the child is present and the documented time. We do require our providers document separately their time spent on test administration, on test interp/report writing, and in reviewing results/recommendations with family.

  7. Default
    Thanks everyone for your assistance with this. My new provider has been putting all his time down for it, giving the test one day, scorring the next day, interpreting and writing the report maybe another day. I have been confused if I'm supposed to bill it all at once or each date.

    Thank you for your input and advice I appreciate it.


  8. #8
    Default 96101 or 96118 for pre-op examination
    If my provider (neuropsych PHD) is performing testing for presurgical clearance (SCS and epilepsy surgery) should i be using 96101 or 96118? Is it the actual tests performed that decides what to use? is it the reason for the testing? i'm totally confused on these ones. Any help would be great!
    Last edited by trinapitsch; 10-03-2013 at 06:31 AM.

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