Primary Care Coding Alert

Reader Questions:

Autism Screenings Falls Under 96110

Question:Is there a CPT code for administering the M-CHAT screening? Do we need to include a modifier?West Virginia SubscriberAnswer:Submit 96110 (Developmental testing; limited [e.g., Developmental Screening Test II, Early Language Milestone Screen], with interpretation and report) when you administer the Modified Checklist for Autism in Toddlers (M-CHAT). If, at the same visit, staff administer a second different screening tool (such as the ASQ, Ages and Stages Questionnaire), some payers will allow you to report 96110 with 2 units. Other payers may require you to report 96110 a second time appended with modifier 59 (Distinct procedural service). Multiple screenings typically occur at a child's 10-month visit (99381, Initial comprehensive preventive medicine evaluation and management of an individual ... new patient; infant [age younger than 1 year] or 99391, Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, [...]
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