Pediatric Coding Alert

Question: Our insurer has been denying all of our claims when we report 96110 with V20.2. Can you advise a better diagnosis code to report with these screening tests?

Texas Subscriber

Answer: If the patient has any symptoms that prompted you to perform developmental screening, you should report the appropriate diagnosis code for those conditions instead of V20.2 (Routine infant or child health check with 96110 (Developmental screening, with interpretation and report, per standardized instrument form).

If the pediatrician performs the screening specifically for suspected developmental handicaps, you could consider V79.3 (Screening developmental handicaps early childhood). If a problem is found, also code the condition, such as 315.31 (Expressive language disorder).