Neuro psychological testing CPT® 96120

When would it be appropriate for an MD to bill for and Established patient Office Visit and CPT® 96120?

Thank you
Maria

re: Neuro psychological testing CPT® 96120

Probably if the patient has a concurrent condition (different diagnosis) which was addressed during the visit, then bill both 96120 and add modifier 25 to code 992xx (assign a separate diagnosis for the concurrent condition treated (E/M)). Assign the diagnosis responsible for billing 96120.

re: Neuro psychological testing CPT® 96120

Thanks for your help, it appears from the documentation that these are pre planned and the decision to perform the test was made at a prior visit.

Maria

re: Neuro psychological testing CPT® 96120

No E/M medically necessary in that case.

re: Neuro psychological testing CPT® 96120

I am not able to find any documentation that states the e/m is not billable with the 96120 utilizing the same Dx. Can you please provide such?
My findings reflect that if you have the documented components met for an e/m and there is nothing in the CPT® guidelines specifying that there must be a separate Dx code then the e/m is billable with a -25 modifier.
We have had several occasions where our provider will do a complete neuro exam, which includes the balance testing etc that are related to the concussions plus the history and mdm are presented... all have been determined as billable with the 96120 ImPact testing. If there is documentation that states this is incorrect coding I would greatly appreciate having such so we can correct our practices asap.
thank you