Depression Standardized screening Patient Health Brief emotional/ 96127 may be combined with other screening screening tool is recommended; if Questionnaire-9 behavioral assessment codes (ex. W7000) for a maximum of 2 units providers choose, they may be billed only when a of screening per visit can with Beck Depression standardized screening “pre-screen” PHQ-2 to determine if a Inventory (BDI) tool is used and results longer screen is needed documented. PHQ-2 may not be billed. Substance Use Standardized screening Alcohol Use Disorders W7000: Alcohol and/or A maximum of 1 unit of W7000 or W7010 will Screening tool is recommended Identification Test substance use disorder be reimbursed annually for recipients age 11 Drug Abuse Screening screening, and up Positive screens should be Test (DAST) administered may be followed by Alcohol, Smoking, and billed only when a and W7010 may be combined with other intervention and referral Substance Involvement standardized screening codes (ex. 96127) for a maximum for treatment when test (ASSIST) administered tool is used of 2 units of screening per visit indicated (SBIRT: CRAFFT (under 21) Screening, Brief W7010: Alcohol and/or A maximum of 4 interventions will be Intervention, and Referral substance use disorder reimbursed annually per recipient age 11 and to Treatment) screening, provider up may be billed only when a standardized provider tool is used W7020: Intervention; > 3 minutes up to 10 minutes W7021: Intervention; >10 minutes up to 20 minutes W7022: Intervention; >20 minutes Procedure Code Description Current reimbursement 2017
Depression screening Standardized screening tool is recommended; if providers choose, they can “pre-screen” with PHQ-2 to determine if a longer screen is needed Patient Health Questionnaire-9 Beck Depression Inventory (BDI) Brief emotional/ behavioral assessment may be billed only when a standardized screening tool is used and results documented. PHQ-2 may not be billed. 96127 may be combined with other screening codes (ex. W7000) for a maximum of 2 units of screening per visit Substance Use Screening Standardized screening tool is recommended Positive screens should be followed by intervention and referral for treatment when indicated (SBIRT: Screening, Brief Intervention, and Referral to Treatment) Alcohol Use Disorders Identification Test Drug Abuse Screening Test (DAST) Alcohol, Smoking, and Substance Involvement test (ASSIST) CRAFFT (under 21) W7000: Alcohol and/or substance use disorder screening, may be billed only when a standardized tool is used W7010: Alcohol and/or substance use disorder screening, provider administered may be billed only when a standardized provider administered tool is used W7020: Intervention; > 3 minutes up to 10 minutes W7021: Intervention; >10 minutes up to 20 minutes W7022: Intervention; >20 minutes A maximum of 1 unit of W7000 or W7010 will be reimbursed annually for recipients age 11 and up and W7010 may be combined with other screening codes (ex. 96127) for a maximum of 2 units of screening per visit A maximum of 4 interventions will be reimbursed annually per recipient age 11 and up Procedure Code Description Current reimbursement 2017
Coding-Guidelines-for-Screening-Tools-Primary-Care-final.docx