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Coding 96101 with 96102 and or 96103

  1. Default Coding 96101 with 96102 and or 96103
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    I need help with intrepretation of this grouping. Per CTP codebook, 96101 cannot be filed for the intrepretation and report for 96102 or 96103 however, when this is put into NCCI, it states that they can be filed together with modifier. HELP. I need absolute clarification on this to go before my medical board. If you file behavioral health - can you tell me your best practices. Thanks.

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    Quote Originally Posted by msgriffi View Post
    I need help with intrepretation of this grouping. Per CTP codebook, 96101 cannot be filed for the intrepretation and report for 96102 or 96103 however, when this is put into NCCI, it states that they can be filed together with modifier. HELP. I need absolute clarification on this to go before my medical board. If you file behavioral health - can you tell me your best practices. Thanks.
    If you post your question on the Behavioral Health forum you might get quicker responses, some folks only subscribe to certain forums for their specialty and might not see your question here.

    In case it helps, when I looked up these codes in the Encoder Pro the descriptions make them pretty clear, all of the codes include the interpretation and report by a qualified health care professional; but the first code is for the psychologist or physician doing the testing and the interpretation w/reports, the second one is if a technician administers the tests but the health care provider interprets and reports, and the third one is of a computer administers the tests and the health care provider interprets and report:

    "96101 Psychological testing (includes psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, eg, MMPI, Rorschach, WAIS), per hour of the psychologist's or physician's time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report "

    "96102 Psychological testing (includes psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, eg, MMPI and WAIS), with qualified health care professional interpretation and report, administered by technician, per hour of technician time, face-to-face "

    "96103 Psychological testing (includes psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, eg, MMPI), administered by a computer, with qualified health care professional interpretation and report "
    Last edited by ajs; 12-20-2011 at 12:30 PM. Reason: addition
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

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