No modifier is necessary because the commercial payer does not bundle 96110 with 99392 and allows two units per date of service as the maximum allowable for code 96110. 96160 96161 CPT 96160, Under Health Behavior Assessment and Intervention Procedures The Current Procedural Terminology (CPT ) code 96160 as maintained by American Medical Association, is a medical procedural code under the range - Health Behavior Assessment and Intervention Procedures. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, AMA Plaza 330 N. Wabash Ave., Suite 39300, Chicago, IL 60611-5885. Applicable Federal Acquisition Regulation Clauses (FARS)/Department of Defense Federal Acquisition Regulation supplement (DFARS) Restrictions Apply to Government Use. Please review and accept the agreements in order to view Medicare Coverage documents, which may include licensed information and codes. The CPT guidelines for 96156-96161 provide an important reminder about how 96160/96161 differ from two other screening and assessment codes: 96110 (Developmental screening [eg, developmental milestone survey, speech and language delay screen] with scoring and documentation, per standardized instrument) and 96127 (Brief emotional/behavioral For example, Aetna clearly encourages and pays for depression screening reported with code 96127 and ICD-10 code Z13.89, Encounter for screening for other disorder. Cigna has a national policy that provides separate coverage of developmental screening (96110), brief behavioral health assessment (96127), and depression screening reported with HCPCS code G0444. The AMA does not directly or indirectly practice medicine or dispense medical services. A few payers do indicate that a report (separate from the E/M service documentation) is also required, so verify your payers' documentation requirements prior to providing these services. When 96160 is billed with CPT code 96127: modifier 59 must be added to the EP modifier To indicate Referrals use Z00.121 (pg. Please Note: For Durable Medical Equipment (DME) MACs only, CPT/HCPCS codes remain located in LCDs. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT.
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