Refer to the current HCPG for examples of other scientifically validated screening tools for adolescent health risk. Codes 96110, 96160, and 96161 are typically limited to developmental screening and the health risk assessment (HRA). The AMA assumes no liability for data contained or not contained herein. This is often included in the test itself, but these elements may alternatively be documented in the progress report of the visit. The healthcare providers analysis of the results and assigned score. Depression screening is not separately reported in conjunction with a Medicare initial preventive physical examination (IPPE, Welcome to Medicare exam) or an initial Medicare annual wellness visit (AWV). Compliance with the provisions in LCD L33834, Health and Behavior Assessment/Intervention may be monitored and addressed through post payment data analysis and subsequent medical review audits. The CPT guidelines for 96156-96161 provide an important reminder about how 96160/96161 differ from two other screening and assessment codes: 96110 (Developmental screening [eg, developmental milestone survey, speech and language delay screen] with scoring and documentation, per standardized instrument) and 96127 (Brief emotional/behavioral assessment with scoring and documentation, per standardized instrument). License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, AMA Plaza 330 N. Wabash Ave., Suite 39300, Chicago, IL 60611-5885. recipient email address(es) you enter. Medicare contractors are required to develop and disseminate Articles. The CPT Codes discussed in this Billing and Coding Article are used to report the services provided during testing of the cognitive function of the central nervous system. Alcohol and Substance Abuse Screening and Brief Intervention (i.e., CRAFFT) pg. This First Coast Billing and Coding Article for Local Coverage Determination (LCD) L33834 Health and Behavior Assessment/Intervention provides billing and coding guidance for frequency limitations as well as diagnosis limitations that support diagnosis to procedure code automated denials. The HRA codes 96160 (Administration of patient-focused health risk assessment instrument [eg, health hazard appraisal] with scoring and documentation, per standardized instrument) and 96161 (Administration of caregiver-focused health risk assessment instrument [eg, depression inventory] for the benefit of the patient, with scoring and documentation, per standardized instrument) like all the health behavior assessment and intervention codes (96156-96161) are used to identify and address the psychological, behavioral, emotional, cognitive, and interpersonal factors important to the assessment, treatment, or management of physical health problems, according to CPT guidelines. Getting Paid for Screening and Assessment Services | AAFP There are multiple ways to create a PDF of a document that you are currently viewing. For this supplementary claims processing information we rely on other CMS publications, namely Change Requests (CR) Transmittals and inclusions in the Medicare Fee-For-Service Claims Processing Manual (CPM). It is appropriate to bill the 96160 CPT code when a healthcare provider administers a standardized patient-focused health risk assessment instrument, scores the results, and documents the findings in the patients medical record. Instrument-based assessment of potential emotional and/or behavioral problems (e.g., depression, attention-deficit), Patient Health Questionnaire-9, Edinburgh Postnatal Depression Scale (administered for the benefit of the mother), and NICHQ Vanderbilt Assessment Scales. an effective method to share Articles that Medicare contractors develop. Copyright 2017 by the American Academy of Family Physicians. This article is being retired effective for dates of service on and after 12/08/2022 because the related LCD is being retired.
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