Pediatric Coding Alert

Your developmental screening tests will soon be split into two separate codes.

Your practice probably performs many developmental screenings every day, so you’re quite familiar with how to report 96110. Unfortunately, you’ll soon have to adjust your thinking about this code, thanks to several big coding changes that will take place Jan. 1. 

As we reported in Pediatric Coding Alert Vol. 17, no. 10, the new CPT® codes for 2015 will impact services like fluoride varnish and chronic care management, and today we’ll take a look at what the New Year will have in store for you when it comes to your behavioral assessment services.

Get Ready for 96110’s New Use

Although you currently report 96110 (Developmental screening, with interpretation and report, per standardized instrument form) for all of your developmental screening tests, it will be reserved for just development, speech and language delay testing starting in January. The code will be revised to say “Developmental screening (eg, developmental milestone survey, speech and language delay screen), with scoring and documentation, per standardized instrument.”

What this means: Not only can you no longer report 96110 for your ADHD screens, you must specifically have documentation that your provider evaluated a potential developmental and/or speech or language delay before you can bill this code in the New Year.

Welcome 96127

If you’re wondering how you’ll bill your ADHD or depression screenings come January, it’s a good time to memorize new code 96127 (Brief emotional/behavioral assessment [eg, depression inventory, attention-deficit/hyperactivity disorder [ADHD] scale], with scoring and documentation, per standardized instrument). Some of the standardized forms that your clinician might employ for this service will include the Vanderbilt Rating Scale, Patient Health Questionnaire-9 (PHQ-9), Zung Self-Rating Depression Scale, or the Beck’s Depression inventory for assessing the patient for depression. Some such questionnaires that your clinician might use for ADHD will include Conners’ Parent and Teacher Rating Scale, ADHD Self-Rating Scale, or the Brown Attention Deficit Disorder Scale (BADDS). 

Although the code descriptor for 96127 doesn’t specifically mention autism, the MCHAT screening for autism will fit more appropriately under this new code, since the MCHAT is much more than a speech and language delay screening. Because the MCHAT form asks about topics such as make-believe play, walking, and participation in movement activities in addition to its questions about language and hearing, 96127 will be the more appropriate code for these services in 2015.

It is unclear what payment amounts will be assigned to 96127, and whether your payment will change for 96110 effective Jan. 1. Keep an eye on Pediatric Coding Alert for more on this topic as 2015 gets closer for updates.