96127 brief screening behavioral health and development

Is this code intended to capture a brief primary care assessment? What code or codes are used for psychological or neuropsychological testing? Would like to make sure we are clearly understanding and utilizing this particular code.

Comments

  • According to CPT Assistant, August 2015, CPT 96127 was new for 2015. This code specifies that a standardized instrument must be used. CPT Assistant defines a standardized instrument as "previously validated tests that are administered and scored in a consistent or "standard" manner." If the practitioner is utilizing a standard instrument, and it is documented in the medical record that the information was reviewed/utilized during the visit for care of the patient, then this code can be reported. The documentation of the use/consideration of the tool during the practitioner's assessment is critical in order to have a billable service. The tool can be administered by clinical staff, but there has to be documentation specific to the individual patient to support reporting the code.

    As far as "other codes" for testing, it depends on the format - there are codes for computer based/automatic scoring assessments, etc. The "Central Nervous System Assessments/Tests (eg, neuro-cognitive, mental status, speech testing)" section of CPT provides definitions and guidelines for the use of these tests. My best advice is to review the guidelines, types of assessments being performed, and talk with your practitioner to ensure that the supports the testing that is being performed.

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