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Thread: Cpt 96116

  1. #1
    Join Date
    Apr 2007
    Posts
    518

    Default Cpt 96116

    Neurobehavioral status exam

    Is anyone using this in a Family Pratice setting.
    Say for Dementia.

    If so, what test are you using and what do you look for in real time documentation, from your physician.


    Respectfully
    Daniel,CPC

  2. #2

    Default

    96116 is a mini mental exam - it's a series of questions and a general assessment of the patients mental status normally for dementia or another neuro disorder. it's not a test like you are thinking where they hook you up to a machine or something. If you look in the 1997 DG's under psych - these bullets ARE the mini mental exam. and they are typically bundled with E/M's.

  3. #3
    Join Date
    Apr 2007
    Posts
    518

    Default

    I'm trying to go somewhere with this code.
    Just brain storming.
    Going off what you've written. Sounds like your saying to bundle mini mental testing into an E/M. Vs trying to use CPT 96116.

    But out of curiousity. Say we have an elderly patient come in, the physician is familar with him. And he comes in for a follow up on HTN. While addressing this, the elder's son that came along with the elderly patient says his dad seems to be suffering from some memory loss. So the physician does a mini mental exam on the elderly patient, outside of the care for HTN. Also spends up to the hour needed to meet the requirments for CPT 96116.

    Can I bill CPT 9921X. 25 - 401.1
    99116. 780.93


    Respectfully
    Daniel, CPC

  4. #4

    Default

    Quote Originally Posted by daniel View Post
    I'm trying to go somewhere with this code.
    Just brain storming.
    Going off what you've written. Sounds like your saying to bundle mini mental testing into an E/M. Vs trying to use CPT 96116.

    But out of curiousity. Say we have an elderly patient come in, the physician is familar with him. And he comes in for a follow up on HTN. While addressing this, the elder's son that came along with the elderly patient says his dad seems to be suffering from some memory loss. So the physician does a mini mental exam on the elderly patient, outside of the care for HTN. Also spends up to the hour needed to meet the requirments for CPT 96116.

    Can I bill CPT 9921X. 25 - 401.1
    99116. 780.93


    Respectfully
    Daniel, CPC
    Sometimes you can do it that way - but most will not pay for it that way because they will still bundle it. If you prefer to do it this way, check with your payers first.

    So what I advise the physicians to do is to use the bullets in the psych system to calculate the level of exam - so for example, you may have had an Expanded Problem Focused exam for the HTN alone, but with the added bullets from psych, you have a Detailed exam.

    Do you see what I mean?

  5. #5
    Join Date
    Apr 2007
    Posts
    518

    Default

    Great input, I'll steer away from this code. Was just brainstorming to see if I can get some more reimbursement for my physicians.


    Respectfully
    Daniel, CPC

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