Neurology & Pain Management Coding Alert

Question: What rules apply to billing 96118 and 96119? I haven't found many details from CMS other than confirmation that they reimburse the services.

Connecticut Subscriber

Answer: The biggest difference between these two codes is the person administering the test. If your physician administers the test, report CPT 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 with the patient and time interpreting test results and preparing the report).

If a technician conducts the test, report CPT 96119 (Neuropsychological testing [e.g., Halstead-Reitan Neuropsychological Battery, Wechsler Memory Scales and Wisconsin Card Sorting Test], with qualified healthcare professional interpretation and report, administered by technician, per hour of technician time, face-to-face).

Remember: Both 96118 and 96119 are -per hour- codes, so you report the appropriate code multiple times if the tests last more than one hour.

Student note: Some physicians allow their students to conduct the test and expect to bill 96119. You should only do this, however, if the student is also professionally qualified and licensed as a technician to administer the test. If he isn-t, you-ll do better to have a physician or qualified technician complete the test instead.