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Peason Psych Eval's for Stim Trials

  1. #1
    St. Joseph County, Indiana
    Default Peason Psych Eval's for Stim Trials
    Medical Coding Books
    Coding issues aside, I have never recommended pain physicians use Pearson office based tests for spinal cord stimulator trial patients. My main reason is that since it is difficult at best for trained psychological professionals to accurately determine the "fitness" of patients for stimulator placements, I do not know how a pain physician with little or no psyche training can give a reasonable opinion. I work with several clinics who have performed a combined 150 stim trials a year. I come across two or three psyche eval's a month from psyche specialists where the psychiatrist or psychologist really struggles with the patients appropriateness for the stim trial.

    I guess I may be exaggerating the problem since these technician administered eval's must be paying pre-determinations and pre-certs, right?


    Brock Berta

  2. #2
    Denver Colorado
    This was a Q&A in the November 2009 CPT Assistant:

    Question: For patients being assessed for low back pain, some providers administer and then assess, and may over time follow with tests, such as the Roland-Morris Low Back Pain and Disability Questionnaire, the Oswestry Disability Questionnaire, and similar back or spinal assessment questionnaires. Can these be reported using codes 96101-96125, (Central Nervous System Assessments/Tests [eg, Neuro-Cognitive, Mental Status, Speech Testing])? If not, how should these be reported?

    Answer: Tests of this type are not separately reported using codes 96101-96125 or other CPT codes; instead, they are part of the Evaluation and Management (E/M) services provided. The tests are completed by the patient and in the public domain, so there are no additional supply costs and the provider work involved falls within the E/M services (or "evaluation" or "re-evaluation" codes for therapists), as part of the collection of information and assessment of the patient.

  3. #3
    St. Joseph County, Indiana
    Thanks for your reply MarvelH.

    This was more of a philosophical question than a coding question. I was wondering out loud about whether or not pain specialists should use the Pearson Psyche assessment. Some pain specialists tend to see it as a (small) revenue source and forget the importance of a true psych assessment.

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