How To Use CPT Code 96132

CPT 96132 is a code used for neuropsychological testing evaluation services performed by a physician or other qualified healthcare professional; this article will cover its description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples.

1. What is CPT 96132?

CPT 96132 is a medical billing code used to describe neuropsychological testing evaluation services performed by a physician or other qualified healthcare professional. These services include the integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, family member(s), or caregiver(s) when performed during the first hour of testing.

2. 96132 CPT code description

The official description of CPT code 96132 is: “Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, family member(s) or caregiver(s), when performed; first hour.”

3. Procedure

  1. The provider explains the neuropsychological tests to the patient, parent, and/or guardian and answers any questions they ask.
  2. He administers the tests in writing or orally.
  3. He administers neuropsychological tests which are specifically designed to measure a psychological function known to be linked to a particular brain structure or pathway.
  4. He administers these tests to a single patient in a quiet office environment, free from distractions.
  5. Using standardized tests, the provider conducts a thorough assessment of a patient’s cognitive and behavioral changes following trauma or illness affecting the nervous system.
  6. He performs a battery of tests to measure the patient’s mental abilities in terms of short– and long–term memory, logical reasoning, language skills, visual–motor coordination, problem–solving ability, attention and concentration, and learning ability.
  7. He interprets the test results in the context of the patient’s clinical condition, arrives at a diagnosis, and formulates a treatment plan.
  8. He may discuss all this with the patient and family members or caregivers.

4. Qualifying circumstances

Eligibility for CPT code 96132 services is determined by the patient’s need for neuropsychological testing evaluation. This may be due to a variety of reasons, such as cognitive or behavioral changes following trauma or illness affecting the nervous system, suspected neurodevelopmental disorders, or other conditions that may impact cognitive functioning. The provider must be a physician or other qualified healthcare professional with the appropriate training and expertise in administering and interpreting neuropsychological tests.

5. When to use CPT code 96132

It is appropriate to bill CPT code 96132 when a physician or other qualified healthcare professional performs neuropsychological testing evaluation services for a patient during the first hour of testing. This includes the integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, family member(s), or caregiver(s) when performed.

6. Documentation requirements

To support a claim for CPT 96132, the following information should be documented:

  • Patient’s demographic information, including age, gender, and relevant medical history.
  • Reason for referral to neuropsychological testing evaluation services.
  • Specific tests administered and their results.
  • Interpretation of test results in the context of the patient’s clinical condition.
  • Diagnosis and treatment plan based on the test results.
  • Interactive feedback provided to the patient, family member(s), or caregiver(s) when performed.
  • Time spent on each component of the service, including test administration, interpretation, and feedback.

7. Billing guidelines

When billing for CPT code 96132, it is important to follow the appropriate guidelines and rules. These may include:

  • Only billing for the first hour of neuropsychological testing evaluation services.
  • Using CPT code 96133 for each additional hour spent in neuropsychological testing.
  • Ensuring that the provider is a physician or other qualified healthcare professional with the necessary training and expertise in administering and interpreting neuropsychological tests.
  • Providing thorough documentation to support the claim, as outlined in the documentation requirements section.

8. Historical information

CPT 96132 was added to the Current Procedural Terminology system on January 1, 2019. There have been no updates to the code since its addition.

9. Similar codes to CPT 96132

Five similar codes to CPT 96132 include:

  • CPT 96133: This code is used for each additional hour spent in neuropsychological testing, beyond the first hour covered by CPT 96132.
  • CPT 96136: This code is used for psychological or neuropsychological test administration and scoring by a technician, for the first 30 minutes.
  • CPT 96137: This code is used for each additional 30 minutes of psychological or neuropsychological test administration and scoring by a technician.
  • CPT 96138: This code is used for psychological or neuropsychological test administration and scoring by a physician or other qualified healthcare professional, for the first 30 minutes.
  • CPT 96139: This code is used for each additional 30 minutes of psychological or neuropsychological test administration and scoring by a physician or other qualified healthcare professional.

10. Examples

Here are 10 detailed examples of CPT code 96132 procedures:

  1. A 45-year-old patient with a history of traumatic brain injury undergoes neuropsychological testing to assess cognitive functioning and determine appropriate treatment interventions.
  2. A 60-year-old patient with suspected Alzheimer’s disease receives neuropsychological testing to confirm the diagnosis and develop a treatment plan.
  3. A 30-year-old patient with a history of multiple concussions undergoes neuropsychological testing to evaluate cognitive and behavioral changes and determine the need for further intervention.
  4. A 12-year-old child with suspected attention deficit hyperactivity disorder (ADHD) receives neuropsychological testing to confirm the diagnosis and develop a treatment plan.
  5. A 50-year-old patient with a history of stroke undergoes neuropsychological testing to assess cognitive functioning and determine appropriate rehabilitation strategies.
  6. A 20-year-old patient with a history of epilepsy receives neuropsychological testing to evaluate cognitive functioning and determine the need for adjustments in treatment.
  7. A 40-year-old patient with a history of brain tumor undergoes neuropsychological testing to assess cognitive functioning following tumor resection and develop a treatment plan.
  8. A 70-year-old patient with suspected Parkinson’s disease receives neuropsychological testing to confirm the diagnosis and develop a treatment plan.
  9. A 55-year-old patient with a history of multiple sclerosis undergoes neuropsychological testing to evaluate cognitive functioning and determine the need for adjustments in treatment.
  10. A 65-year-old patient with suspected dementia receives neuropsychological testing to confirm the diagnosis and develop a treatment plan.

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