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Coding for dyslexia diagnostic testing

  1. #1
    Question Coding for dyslexia diagnostic testing
    Clearnace Sale
    Help. This is not an area I've had to do coding for before and I keep looking thru the CPT book at the different options and getting lost.
    Patient had the following tests adminsitered:
    Weshler Adult Intelligence Scale (WAIS-IV)
    Comprehensive Test of Phonological Processing (CTOPP)
    Diagnostic Assessments of Reading (DAR)
    Gray Oral Reading Test-4 (GORT-4)
    Test of Word Reading Efficiency (TOWRE)
    Criterion Referenced Spelling Test-II (CRST-2)
    Test of Written Language (TOWL-4)

    1st test was administered by the psych, all others administered by a technician, results were evaluated and report written by a psyc.

    I have no clue where to begin coding for this. The end diagnosis was severe dyslexia,and I can code the diagnosis under 784.61, but for the CPT coding, I'm lost. Any dyslexia guru's out there that no how to code the diagnostic tests for dyslexia?

  2. #2
    WAIS= 96101 per hour (has to be 31-89 min as 1 hour; 90-149 min is 2 hrs and so on)

    the rest are coded as 96102, which is per hour of tech time. i think you would have to add up all his time and bill based on that time. I am not sure if this code includes time for dr to write her report or not. I will try to look up tomorrow if I have time.

  3. #3
    Jacksonville River City FL
    Yes, you should add up the tech time and bill as 96102. This code includes scoring and report (of these tests) so only the face-to-face time with the patient is billed. Bill 96101 for the test administered by the psych as well as additional time for integration of all data (tech tests, psych tests, CBCLs, etc) and comprehensive report. Most payors want a 59 modifier.

  4. #4
    Default Thanks so much
    Thanks so much everyone for your insightful information on this subject. It's been very helpful.

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