tci ED Coding & Reimbursement Alert - 2015 Issue 11

Reader Question: Use This Feedback to Improve Your Behavior Modification Coding

Question: Can we report services involving behavior modification counseling in the ED? What are the general requirements for these types of services? Texas Subscriber Answer: You can if you meet the requirements of the counseling risk factor reduction and behavior change intervention in CPT®.   These codes (99406-99409) describe face-to-face services provided by a physician or other qualified healthcare professional.  In the ED setting, as in other sites of service, the emergency physician utilizes a standardized evidence-based screening instruments and tools with reliable documentation and appropriate sensitivity, which are required in order to report any of these...

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