Changes to Coding for Brief Emotional/Behavioral Assessments and Developmental Screenings

By Jose Lopez, Senior Consultant, The Verden Group

Effective January 1, 2015, the 96110 code was revised to distinguish it from a new brief emotional/behavioral assessment code 96127. The revision of 906110 clarifies it as an assessment that is focused on identification of childhood and adolescent developmental levels (e.g., fine and gross motor skills, cognitive level, receptive/expressive and pragmatic language abilities, neuropsychological areas [attention, memory, executive functions] and social interaction abilities), rather than behavioral or emotional status, utilizing a standardized instrument.

The new 96127 code is used for brief emotional/behavioral assessment with scoring and documentation using a standardized instrument. This assessment serves as a mechanism to identify emotional and behavioral conditions that previously may have been underestimated and/or undetected in any age population, such as depression screening and attention-deficit/hyperactivity disorder rating scales. This new code was added to differentiate those instruments that look solely or mainly at behavioral and/or emotional issues from developmental screening which are reported with 96110.

A summary of the revision to 96110 and new descriptor for 96127 is as follows:

  • 96110 – Developmental screening (e.g., developmental milestone survey, speech and language delay screen), with scoring and documentation, per standardized instrument.
  • 96127 – Brief emotional/behavioral assessment (e.g., depression inventory, attention-deficit/hyperactivity disorder [ADHD] scale), with scoring and documentation, per standardized instrument.

A listing of brief emotional/behavioral assessment and developmental screening instruments with their appropriate CPT code is listed in the grid below.