Neurology & Pain Management Coding Alert

Check out these changes to testing -- and watch your telephone consults Don't be fooled. The neurology section of CPT 2008 may include only a few changes, but they-ll make a real difference in your coding -- especially if you routinely code for cognitive performance or neuropsychological testing. Add Another Option for Cognitive Testing You-ll only have one new code to learn for neurology testing when CPT 2008 goes into effect: 96125 (Standardized cognitive performance testing [e.g., Ross Information Processing Assessment] per hour of a qualified healthcare professional's time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report). You could use this new code for traumatic brain injury patients, but don't be surprised if you never report it. "Most neurologists don't use these cognitive testing codes, so this should have very little impact," says Neil Busis, MD, chief of the division of neurology and director of the neurodiagnostic laboratory at the University of Pittsburgh Medical Center in Shadyside. "But you need to know about it since it's new." Watch for Subtle Changes in 96118 CPT 2006 established four new codes to differentiate the various modalities for performing neuropsychological exams. One of these codes (96118) has a slightly revised descriptor, effective Jan. 1, 2008: - 96118 -- Neuropsychological testing (e.g., Halstead-Reitan Neuropsychological Battery, Wechsler Memory Scales and Wisconsin Card Sorting Test), per hour of the psychologist's or physician's time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report. Old language: Previous versions of the code stated, "both face-to-face time with the patient and time interpreting test results and preparing the report." Here's the difference: The new descriptor clarifies that the time you report with 96118 must represent face-to-face testing time or time spent interpreting those test results and preparing the report. In other words, you can't report 96118 for face-to-face time unless your physician is conducting the test. Check Out Time-Based Phone E/M Changes If your physician routinely bills for phone calls to patients or to coordinate a patient's care with other medical professionals, be sure to check out changes in the new E/M section. What's gone: CPT 2008 deletes codes 99371-99373 (Telephone call by a physician to patient or for consultation or medical management or for coordinating medical management with other healthcare professionals [e.g., nurses, therapists, social workers, nutritionists, physicians, pharmacists] ...). What's added: You have three new time-based codes, however, for similar services to patients: - 99441 -- Telephone evaluation and management service provided by a physician to an established patient, parent or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an [...]