There is no CPT® code for the Mini Mental Status Exam.
Physicians use the mini mental status exam (MMSE to test a patient's cognitive function. The test is made up of a set of questions, testing the patient’s memory, orientation and arithmetic calculation skills.
There is a copyrighted form of the test available, called the Folstein Test. According to the authors, “The MMSE is a brief, quantitative measure of cognitive status in adults. It can be used to screen for cognitive impairment, to estimate the severity of cognitive impairment at a given point in time, to follow the course of cognitive changes in an individual over time, and to document an individual’s response to treatment.”
Physicians and coders will not find a CPT® code for performing a mini mental status exam. At the beginning of the CPT® section on central nervous system assessments and tests, it reads, "For mini mental status examination performed by a physician, see evaluation and management services codes." Assessing a patient’s memory, orientation, and arithmetic calculation skills are part of an E/M service. Do not use any of the tests in the central nervous system assessment section (96101 to 96125), to report a MMSE.
Payment for assessing these functions is included in the payment for the evaluation and management service. An E/M service includes consults, hospital visits, new or established patient visits. The psychiatric assessment included in the MMSE is part of the 1997 single organ system exam. Or, using the 1997 General Multi-system Exam, there are four psychiatric elements which can be documented. Documenting these may or may not raise the level of service the clinician can bill. But, whether it does or not, there is no separate billing or payment for the MMSE.
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.
There are three main code sets and Healthcare Common Procedure Coding System (HCPCS), is the third most common code set used. They are often called Level II codes and are used to report non-physician products supplies and procedures not found in CPT, such as ambulance services, DME, drugs, orthotics, supplies, ...
We billed 2 units of L3020 but were denied for not using the right modifiers. What should we do?
Rather than submitting two units of the L3020 to indicate that the patient one orthotic for each foot, you would need to use modifiers identifying left foot and right foot. Appropriate coding ...
Two separate pieces of legislation introduced in the House of Representatives (H.R. 2883 and H.R. 3654) have the potential to change some of Medicare’s policies regarding doctors of chiropractic. Find out what these two bills are all about and how they could affect Medicare policies.
The Department of Health and Human Services (HHS) founded its Office of Inspector General (OIG) in 1976 and tasked it with the responsibility to combat waste, fraud, and abuse within Medicare, Medicaid, and the other HHS programs. With approximately 1,600 employees, HHS OIG is the largest inspector general's office within ...
On July 29, 2019, CMS released their proposed rule for the Medicare Physician Fee Schedule for 2020. Last year’s final rule “finalized the assignment of a single payment rate for levels 2 through 4 office/outpatient E/M visits beginning in CY 2021.” It also changed some of the documentation requirements (e.g., ...
What if my Medicare patient refuses to fill out the outcome assessment questionnaire?
Inform the patient that Medicare requires that you demonstrate functional improvement in order for them to determine if the care is medically necessary. In other words, they may have to pay for the care out of pocket if ...
Who knew that when Jack & Jill when up the hill to fetch a pail of water, they would have to ensure that in order to keep the level of water the same on the way back down, they would need to both support the pail.
Many of you in this industry are ...