Do you realize that even in the case when there is still no clinical indication, neuropsychological tests can expose cognitive problems, which means that they have medical value?
Indeed, early testing is an important aspect of contemporary mental care, particularly in the context of neuropsychological test administration. However, these assessments are even medically necessary, yet proper billing for psychological or neuropsychological testing is so much more important so that practices can get reimbursement promptly. In comes CPT codes 96132 and 96133. The codes, which are applied in the evaluation of psychological and neuropsychological tests, are very important when it comes to the medical billing and coding services workflow. They can cost the providers a fortune in time losses and revenues due to misuses or misunderstandings.
What is Neuropsychological Testing Evaluation?
A neuropsychological test is a type of psychological evaluation that examines cognitive functioning in the brain and behaviour. In contrast to general psychological testing, neuropsychological assessments examine further :
- Memory
- Executive Functioning
- Language Processing
- Visuospatial Abilities
What Is CPT Code 96132?
CPT code 96132 corresponds to the first hour of an initial neuropsychological testing assessment that a psychologist or neuropsychologist with a clinical license engages in face-to-face time as he/she goes through records, analytically interprets data, and develops a patient assessment.
CPT Code 96132 Description
Physician or other qualified healthcare professional assessment services in the form of neuropsychological testing, which involve integration of patient data, interpretation of standardized test data, clinical decision-making, treatment planning, and preparation of report; first hour.
This code cannot be applied in the running of the actual psychological test- that is, under different codes.
What is CPT code 96133?
In the case of psychological and neuropsychological tests, there exist various types of services you will be required to record as being provided; some of these services include test evaluation services, test administration, and scoring, as well as a neurobehavioral status exam.
CPT Code 96133 Description
Every hour of neuropsychological testing evaluation services of evaluation above the 96132-covered-hour bailiwick.
What needs to be mentioned is the fact that the add-on code of 96133 is not stand-alone; in other words, it has to be charged along with the code 96132 and cannot be billed separately on the day of service.
Key Differences between CPT Code 96132 and 96133
Each of them acquired particular CPT codes, and one of these is 96133. This code is connected closely to 96132, the code that takes care of the initial hour of the neuropsychological examination calculations of a qualified healthcare expert. It has the tasks of data integration by patient data, data interpretation, standardized test results, clinical decision-making, planning of the treatment process, and assistance in notifying the patient or the individual looking after them with feedback.
CPT code 96133 is an add-on code that should be used after the first hour. This code would apply to you in cases where your assessment goes beyond the first hour that has been covered with 96132. It assists in coding the extra time and effort needed to undertake more deep-rooted evaluations.
Real-Life Example
The case involved a 15-year-old boy who was referred by a school counselor to tackle the attention disorder issue and low performance. Following preliminary screening, an extensive assessment of ADHD was done by a licensed neuropsychologist.
- Tests administered: CPT code in ADHD testing, MCHAT, and assessment of attention span.
- Total time entering: 2.5 hours to review test results and write the reports, in addition to counseling the family.
CPT Codes Psychological and Neuropsychological Testing
| CPT Codes | Description |
| 96130 | Psychological examination (hour one) is essential for a comprehensive neuropsychological evaluation. |
| 96131 | More time for psychological analysis |
| 96132 | First hour: neuropsychological assessment (first hour) |
| 96133 | Further overtime of neuropsychological testing |
| 96136 | Psychological testing evaluation services are delivered by technicians (first 30 minutes). |
| 96138 | More frequently than technicians inject every 30 minutes |
| 96146 | The automated scoring and testing in psychology |
| 90791 | CPT- psychiatric evaluation (initial without medical services) |
| 96127 | The CPT code for the MCHAT (short test of emotional/behavioral status) is determined by the results of psychological testing. |
One can use multiple psych testing codes to conduct more extensive assessments. As an example, 96132 can be combined with 96138 when the involved technician-administered portions of psychological or neuropsychological testing are performed.
The importance of Accurate Coding in Neuropsych Testing
One of the most frequent causes of denial or delay in reimbursements of behavioral health practices is billing-related; it is the incorrect coding or one-sidedness with regard to Psychological testing CPT codes.
This is what will happen to you as a result of poor coding in the context of medical necessity.
- Rejection of claims based on wrong modifiers.
- Underbilling of long evaluations is a source of revenue leakage.
- Insurance audit compliance, Complaint problem, Authority figures. As a lifelong learner, it is important to understand the adverse effects of insurance audits.
When handling complex diagnoses such as pancytopenia, it’s crucial to apply the right codes. Check out our billing tips for ICD-10 code D61.81 (Pancytopenia) to ensure accurate claim submission.
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Guidelines of CPT: When to Utilize These Codes in Practice
Use 96132/96133 in the following situations:
- Psychological tests have data that are being reviewed and merged by a licensed psychologist or a licensed neuropsychologist.
- Writing a long evaluation report.
- Carrying out complicated psychological examinations about neurological disorders such as dementia, ADHD, stroke, TBI, or learning disorders.
When not to use such codes:
- The only person giving the tests is an administrator (use 96136 or 96138).
- It is a simple psychiatric assessment (you would use the CPT code of a psychiatric evaluation, i.e., 90791).
Conclusion
Proper billing and accurate neuropsychological testing assessment are vital in the diagnosis of cognitive conditions; however, it is equally crucial in obtaining reimbursement using CPT codes such as 96132 and 96133. Useful insight into the difference between the psychological and neuropsychological tests will guarantee compliance and revenue for psychological testing evaluation services. In collaboration with an experienced Medical Billing Company, such as Providers Care Billing LLC, it can make coding easier, decrease denials, and make the practice efficient to provide high-quality mental health care.
FAQS
Q: Is it possible to do a psychiatric assessment of 96132?
No, 90791 or 90792 must be the code for mental testing.
Q: What are CPT Codes 96130 and 96132?
- 96130 = Psychological tests examination
- 96132 = assessment of neuropsychological tests
They are both an hour, but one is used in assessing one type of psychological or neuropsychological evaluation.
Q: Which code is CPT used to identify MCHAT?
MCHAT screening (usually screening for autism in toddlers) should be coded as 96127 on CPT.
