As part of an evaluation of a patient with a concussion, the physician performs a sport concussion assessment tool-5 (SCAT5) and a vestibular ocular motor screening (VOMS) test. Would it be appropriate to report codes 96136 and 96132 for the performance of these testing services and interpretation of their results? ...
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Article Overview
This article explains how a concussion-related evaluation involving named screening tools fits within CPT guidance for psychological and neuropsychological testing services. It is intended for coders, billers, and clinicians who need to understand which general CPT service categories apply, how standardized testing and automated results are treated, and how time-based reporting concepts are described in the CPT Professional codebook. The discussion also references the relationship between administration/scoring services and evaluation services, along with the role of interpretation and reporting.
Why This Topic Matters
Selecting the correct CPT testing service category affects accurate reporting for concussion evaluations and helps avoid misclassification of screening and neuropsychological assessment work. The article also highlights when general time-based CPT guidance and service overlap concepts may be relevant.
Article Sections
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Question on reporting testing services for concussion evaluation
Introduces a scenario involving concussion-related assessment and asks whether certain CPT testing service codes are appropriate for the services performed.
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Explanation of applicable CPT testing categories
Reviews the general CPT service families discussed in the scenario, including test administration, scoring, and testing evaluation services, as well as the role of interpretation and reporting.
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CPT Professional 2023 guidance on testing services and time reporting
Summarizes cited CPT Professional guidance about services that may be performed together and general timing concepts for reporting applicable evaluation services.
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When additional standardized testing may support reporting
Describes the article’s discussion of circumstances in which further standardized testing and related evaluation work may be considered within the broader reporting framework.
What You Will Learn
- How a concussion-related assessment is framed within CPT psychological and neuropsychological testing services.
- Which broad CPT testing service categories are discussed in relation to standardized tests and automated results.
- How CPT time-based reporting concepts are described for evaluation and testing services.
- How the article characterizes overlap between administration/scoring services and evaluation services.
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Clinicians involved in concussion evaluation
- Neuropsychology and psychology practices
Codes Discussed
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