Pediatric Coding Alert

Question: We just starting billing code 99420 (Administration and interpretation of health risk assessment instrument) and the patient's insurance company rejected the claim. When we called them to ask why, they said that we need to use a diagnosis of V79.0 (Screening for depression). However, our patient didn't have depression--we were screening him for ADD (314.00). How should we bill these going forward? Should we just add V79.0?

Michigan subscriber

Answer: Many insurers want you to add a "V" code to these claims to explain the reason for the testing, but you can't add a depression screening code if the physician didn't document it. Instead, select another V code that more accurately describes your patient's condition.

For instance, you might consider V65.49 (Other specified counseling) or V62.3 (Other psychosocial circumstances; educational circumstances).