Intervention, and Referral W7021: Intervention; >10 to Treatment) minutes up to 20 minutes W7022: Intervention; >20 minutes Table 2: Other Pediatric Mental Health Screening/Assessments Recommendation Examples of Acceptable Billing Guidelines Limitations Standardized ADHD AAP clinical policy Vanderbilt ADHD 96127: Brief emotional/ A maximum of 2 units of 96127 will be Assessment recommends use of Diagnostic Rating Scales behavioral assessment reimbursed per visit ADHD-focused parent and Parent and Teacher may be billed only when a – teacher ratings scales as a Conners-3 Ratings standardized screening component of Scales tool is used and results screening/diagnosis when ADHD Rating Scale-5 for documented. there is concern Children and Adolescents Other Disorder-focused mental Screen for Childhood 96127: Brief emotional/ A maximum of 2 of 96127 will be mental health screening and Anxiety Related behavioral assessment reimbursed per visit health assessment tools may be Disorders (SCARED) may be billed only when a screening/ used when there is a Spence Children’s standardized screening assessment specific concern, ex. Anxiety Scale tool is used and results anxiety documented. Table 3: Adult Screening/Assessments for Mental Health and Substance Use Recommendation Examples of Acceptable Billing Guidelines Limitations Standardized Tools
Intervention, and Referral to Treatment) W7021: Intervention; >10 minutes up to 20 minutes W7022: Intervention; >20 minutes Table 2: Other Pediatric Mental Health Screening/Assessments Recommendation Examples of Acceptable Standardized Billing Guidelines Limitations ADHD Assessment AAP clinical policy recommends use of ADHD-focused parent and teacher ratings scales as a component of screening/diagnosis when there is concern Vanderbilt ADHD Diagnostic Rating Scales – Parent and Teacher Conners-3 Ratings Scales ADHD Rating Scale-5 for Children and Adolescents 96127: Brief emotional/ behavioral assessment may be billed only when a standardized screening tool is used and results documented. A maximum of 2 units of 96127 will be reimbursed per visit Other mental health screening/ assessment Disorder-focused mental health screening and assessment tools may be used when there is a specific concern, ex. anxiety Screen for Childhood Anxiety Related Disorders (SCARED) Spence Children’s Anxiety Scale 96127: Brief emotional/ behavioral assessment may be billed only when a standardized screening tool is used and results documented. A maximum of 2 of 96127 will be reimbursed per visit Table 3: Adult Screening/Assessments for Mental Health and Substance Use Recommendation Examples of Acceptable Standardized Tools Billing Guidelines Limitations
Coding-Guidelines-for-Screening-Tools-Primary-Care-final.docx