Pediatric Coding Alert

Question: A pediatrician uses a developmental form that our practice created to check young children's development. At each monthly visit, the parent circles the skills and behaviors that the infant exhibits. The pediatrician then asks a few follow-up questions and tells the parent what he should expect in the months ahead. Should I report the service with 96110?

California Subscriber

Answer: No, you shouldn't report the service with 96110 (Developmental testing; limited [e.g., Developmental Screening Test II, Early Language Milestone Screen], with interpretation and report). You should instead include the simple screening in the age-appropriate preventive medicine service code. Code 96110 describes more than a simple screening that a pediatrician normally performs at early-childhood preventive medicine services (99381-99382, Initial comprehensive preventive medicine evaluation and management of an individual ...; or 99391-99392, Periodic comprehensive preventive medicine re-evaluation and management ...).
 
To use 96110, the pediatrician or nonphysician must administer (or a parent must complete) and interpret a standardized developmental testing tool, such as the Denver Developmental Screening Test II, the Ages and Stages Questionnaire, or the Bayley Infant Neurodevelopmental Screener. These are just some of the tests that qualify as 96110.
 
Code 96110 isn't limited to a few tools. You must, however, use a standardized, studied test that has a consistent application and assessment. Homegrown developmental assessments and general developmental questioning don't meet these requirements.