Wiki Mmse 96116

[adaniel]

Has anyone been able to get paid by MCR for 96116 when billed w/ annual wellness visit?

 

[tdml97@yahoo.com]

Add a 25 mod to visit & rebill. It should get paid. If it comes back, add a 59 mod to 96116 & they will pay for sure.

 

[Cynthia Hughes]

If the mmse you placed in front of 96116 is intended to represent mini mental status exam, code 96116 does not represent that service. The tests represented by code 96116 are more comprehensive and this code is not reported for less than 31 minutes of physician or psychologist's face-to-face time and time interpreting test results and preparing the report. According to CPT Assistant, " The reporting of any additional time incurred for the physician administration, interpretation and written report associated with the MMSE is included in an appropriate level evaluation and management service code for that patient encounter."

The AWV also includes detection of cognitive impairment as a component of the service.
Hope this helps.
Cindy