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Pediatric Coding Alert

Does 96110 Have an Age Limit? It Depends on Who You Ask

Published on Wed Jul 01, 2009

Your developmental testing pay hinges on plan awareness. Not screening your major payers' developmental testing policies can leave the patient -- or your practice -- stuck with the bill. Suppose an office uses the DDST at annual well exams and bills 96110 (Developmental testing; limited [e.g., Developmental Screening Test II, Early Language Milestone Screen], with interpretation and report) for completing the questionnaire and documenting the results. A common question pops up: "Until what age can this be done?" asks Kausar S. Kherani, MD, in Westlake, Ohio. The answer hinges on the guideline you're following. Here's how to maximize your pay. Carriers' Limits Vary by Plan "Even though 96110 has no age limit," carriers may impose restrictions, says Patti DiSpazio, CPC, business manager at Island Coast Pediatrics in Fort Myers, Fla. Some plans may limit the code at age 11, others at age 17. Strategy: You've got to research your major payers' [...]
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