Importance of Depression Screenings

August 16th, 2018 - Wyn Staheli, Director of Research
Categories:   Behavioral Health|Psychiatry|Psychology   Chiropractic   Documentation Guidelines   Billing  
0 Votes - Sign in to vote or comment.

Why would a chiropractor be concerned about depression screenings when you aren’t trained to be a mental health provider? The answer lies in patient outcomes. Many quality care organizations recommend depression screenings for patients with a chronic condition. According to The National Institute of Mental Health, “People with other chronic medical conditions have a higher risk of depression.” This is because depression can not only make a chronic condition worse, but it also can be triggered by illness-related anxiety and stress. Because depression affects how a person manages their health condition, not addressing depression when dealing with a chronic condition can have a negative effect on patient outcomes.

ACA’s “Choosing Wisely” program addresses this topic. They state (emphasis added):

4. Do not provide long-term pain management without a psychosocial screening or assessment.

There is a high probability that any person with a chronic pain syndrome has a concomitant psychological disorder, most notably depression and/or anxiety. The relationship between chronic pain and depression/anxiety is well established. The causal arrow between pain and these disorders can point in either direction and over time may form a positive feedback loop between these two elements. Screening tools are available that will aid in the detection of potential depression/anxiety, and when indicated, a referral may be most appropriate for more extensive evaluation and treatment. In addition, lesser psychological factors such as catastrophizing and fear avoidance behavior may interfere with a patient’s recovery and should be recognized by the clinician. Recognizing indicators of patient psychosocial health behavioral factors can affect a patient’s recovery and/or compliance with treatment and may decrease the risk of developing chronic illness/pain. Tools such as StarTBack 9 screening tool, PHQ-9 depression scale and the Fear Avoidance Belief Questionnaire are examples.

Coverage

Medicare, and many other payers, cover depression screenings because they recognize the preventive benefit(s) of this service. There are a few different code choices for depression screenings. They are:

G0444 - Annual depression screening, 15 minutes


96161 - Administration of caregiver-focused health risk assessment instrument (e.g., depression inventory) for the benefit of the patient, with scoring and documentation, per standardized instrument)


96127 Brief emotional/behavioral assessment (eg, depression inventory, attention deficit/hyperactivity disorder [ADHD] scale), with scoring and documentation, per standardized instrument

Caution: Be careful using code G0444 since that is for an annual screening and Medicare will only cover it when performed by a primary care provider. There are also other payers who cover G0444 (e.g., Aetna, Cigna), so be sure to review individual payer policies to see if doctors of chiropractic are allowed to bill that code. Since the most common situation in a chiropractic setting would be treating a patient for chronic pain (e.g., low back pain), this is not the most applicable code choice.

Documentation

Regardless of the code used, the following information must be included in the documentation:

Payment

There is not a high payment rate for this service. Performing these services is done for quality purposes — not to increase your revenue. The following table shows some sample pricing:

  Workers Comp Medicare
G0444

$24.75

$18.36

96161

$6.31

$3.96

96127

$7.76

$6.48

Additional Considerations

CPT guidelines state that neither 96161 nor 96127 can be billed with E/M services. NCCI edits disallow all three codes when billed with E/M services as they are considered part of (bundled) the E/M service.

Also note that like many preventative services, most payers do not require a specific ICD-10-CM code to be reported with any of these codes.

###

Questions, comments?

If you have questions or comments about this article please contact us.  Comments that provide additional related information may be added here by our Editors.


Latest articles:  (any category)

A 2020 Radiology Coding Change You Need To Know
February 10th, 2020 - Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content
The radiology section of the 2020 CPT© has 1 new, 18 revised, and 14 deleted codes. Interestingly, six of the 14 deleted codes were specific to reporting single-photon computerized tomographic (SPECT) imaging services of the brain, heart, liver, bladder, and others. If your organization reports radiology services, it is...
Documenting telephone calls at your dental practice is just as important as documenting patient visits.
February 4th, 2020 - Christine Taxin
Documenting telephone calls at your dental practice is just as important as documenting patient visits. Similar to other documentation, the common rule when it comes to call documentation is that if it is not documented, it did not happen. Therefore, every clinically relevant telephone call should be documented. Clinically relevant calls ...
CPT 10-Year Historical Content - Now Available!
January 22nd, 2020 - Find-A-Code
Did You Know? We now offer Historical CPT Content in 2-year, 5-year, or 10-year options! Utilize access to specific CPT historical data for previous years using rules effective at that specific time. If you’ve added UCR fees to your account, you can use Historical CPT Content to view UCR fees from ...
Inadequate Exclusion Screenings Could Put Your Practice at Risk
January 21st, 2020 - Wyn Staheli, Director of Research
Exclusion screenings require far more than just checking a name on a federal database at the time you are hiring someone. Far too many providers don’t realize that in order to meet compliance requirements, there is MUCH more involved. There are actually over 40 exclusion screening databases/lists that need to be checked.
Q/A: How do we Bill Massage Services?
January 21st, 2020 - Wyn Staheli, Director of Research
Question: We are adding a massage therapist soon and have some questions about billing their services.
Billing for Telemedicine in Chiropractic
January 14th, 2020 - Evan M. Gwilliam DC MBA BS CPC CCPC QCC CPC-I MCS-P CPMA CMHP
Many large private payers recognize the potential cost savings and improved health outcomes that telemedicine can help achieve, therefore they are often willing to cover it. While there are several considerations, there could be certain circumstances where telemedicine might apply to chiropractic care.
Non-Surgical Periodontal Treatment
January 14th, 2020 - Christine Taxin
AAP treatment guidelines stress that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment.Non-surgical periodontal treatment does have its limitations. When it does not achieve periodontal health, surgery may be indicated to restore periodontal health.SCALING AND ROOT PLANINGScaling ...



About Codapedia by innoviHealth® Contact Us Terms of Use Privacy Policy Advertise with Us

innoviHealth® - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain)

Copyright © 2000-2020 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association