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Pediatric Coding Alert

Reader Question:

Code for Both DDST-II and E/M

Published on Mon Jul 26, 2004

Question: A parent brought her 11-month-old in for testing for delayed language development. My pediatrician evaluated the patient and decided testing was appropriate. He performed the Denver Developmental Screening Test II (DDST-II). Is there a code for this test, or should I just report a high-level E/M code? South Carolina Subscriber Answer: You should report 96110 (Developmental testing; limited [e.g., Developmental Screening Test II, Early Language Milestone Screen], with interpretation and report) for the DDST-II test and the appropriate-level E/M code (99201-99215). To collect separate reimbursement for a fully documented E/M service with developmental testing, you may need to append modifier -25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to the E/M code. -- Information for You Be the Coder and Reader Questions provided by Victoria Jackson, executive director and owner, Omni Management, El Torro, Calif.; and Richard H. Tuck, MD, FAAP, pediatrician at Primecare of Southeastern Ohio in Zanesville.
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