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Cpt 96110

  1. #1
    Cool Cpt 96110
    Clearnace Sale
    Our coder wants to know...is it appropriate to bill CPT 96110 with each and every preventative well-child exam? The provider has just started doing this and she cannot locate specific information on it. Does anyone have specifics what is covered under CPT 96110?
    Ali Coleman ~ CFE, CPC, CEMC
    Defense Health Agency
    TRICARE/Department of Defense
    Health Care Fraud Specialist

  2. #2
    Milwaukee WI
    Default CPT description
    The CPT description includes the names of specific tests used to measure this, and states "with interpretation and report."

    This is not the same as the typical evaluation of developmental milestones all pediatricians perform during a well-child check.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3
    We bill this at the 18 and 24 month well check because we do the MCHAT at that time, however we inform the parent this may not be a covered ben. and leave it to the parent to decide if they want it done

  4. #4
    Default 96110
    The 96110 testing involves each age group. Peds... 0-3 years, mchat 18 mths and 24 months, psc 4-13 years then crafft 14 years and up. Each screening is different and the parent has to fill out the form for it and the doctor evaluates. Some insurances pay for this service and some roll it into the hmv/rov charge. Hope this helps :d

  5. Question 96110 OK to bill as stand alone code?
    If a patient is seen by the pediatrician for the PE for the year and then after the fact is seen for the ADHD testing evaluation (Conners Wells) can the vist be code as a stand alone 96110.

    Does the child even have to be present for the MD to review the forms and determine if they meet the ADHD diagnosis requirements?

  6. #6
    Smile 96110
    The 96110 has nothing to do with the add/adhd evaluation. If the patient or family comes in for the evaluation to see if the patient has the criteria for a diag of add/adhd that would be a 99213-99214 visit depending on what is performed. Usually this would be based on time because its more going over testing and counseling on this type of diag and discussing patient symptoms, behaviors etc. As far as i know, you never bill the 96110 alone. It always is in conjunction with the yearly PE. Hope this helps

  7. Default 96110 OK to bill as stand alone code?
    Hi HBULLOCK Thanks for clarifying it helps very much!

  8. #8
    Glendale Geckoders
    Default Billing code 96110
    Billing code 96110 covers a physician or a non-physician administering a standardized screening instrument to a child's guardian or other observer, and reflects only the physician time reviewing the scores and interpreting the findings with the family (rather than the actual work of giving the survey). Using this code requires documentation that the screen was given and the actions taken

  9. Default 96110-?dx v79.3
    Our department is looking further into charging for 96110. There is a discussion in our office as to what diagnosis should be linked to 96110. On the most part, the physicians are doing this developmental screening during the 18mth-24th Well Child Visits. We are currently using V79.3 to link to 96110. Has anyone encountered any problems linking this diagnosis?

  10. Default
    cpt 96110 - since description states report is generated - where might we get a hold of the form that is completed so we can better understand what the provider reports

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