EM Coding Alert

Question: Can you tell me about code 99420? One of our physicians wants more information about it.

North Carolina Subscriber

Answer: Effective in January 2017, CPT^® deleted evaluation and management (E/M) code 99420 (Administration and interpretation of health risk assessment instrument [eg, health hazard appraisal]).

Now, to report administration of a patient-focused or caregiver-focused health risk assessment instrument, CPT^® advises you to look to the following new codes instead of 99420:

• 96160, Administration of patient-focused health risk assessment instrument (eg, health hazard appraisal) with scoring and documentation, per standardized instrument
• 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.

Unlike 99240, codes 96160 and 96161 say that they include “scoring and documentation, per standardized instrument,” so you know you cannot separately report these services.

In this instance, a “standardized instrument” is defined as a questionnaire created by using criteria that a group of experts established and agreed upon.

Note: According to CPT^®, you shouldn’t report 96160 or 96161 in conjunction with 99408 or 99409 (Alcohol and/or substance [other than tobacco] abuse structured screening ...).