CPT Code 96160 | Description, Procedure & Billing Guidelines (2022)
Report the 96160 CPT code for a standardized survey questionnaire that helps identify a patient’s health risk.
1. What Is CPT Code 96160?
CPT 96160 covers the administration of a questionnaire that helps identify a health risk. The health provider;
- documents the findings;
- assigns a score; and
- analyzes the results.
2. Description
The CPT book describes the 96160 CPT book as: “Administration of patient-focused health risk assessment instrument (e.g., health hazard appraisal) with scoring and documentation, per standardized instrument.”
3. Procedure
The 96160 CPT code procedure aims to identify the risk for a patient regarding a developing health issue with a questionnaire.
The provider assesses the answers to determine if the questionnaire outcome indicates a negative or positive result for the health concern.
Then, the patient gets involved, and the provider reviews the questionnaire results.
The provider documents:
- the discussion with the patient;
- the screening results; and
- the tools that were used.
4. How To Use CPT 96160
CPT code 96160 can be used for every standardized survey questionnaire if the criteria are established and agreed upon by experts).
This procedure includes the administration of the questionnaire, documentation, and scoring. Do not report preparation and scoring separately.
Report CPT code 96161 instead of CPT 96160 for administering a similar instrument to the caregiver of a patient.
5. Resources
https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57754&ver=7&
https://www.wellsource.com/health-risk-assessments/
