How To Use CPT Code 97152

CPT 97152 describes the assessment and identification of destructive behavior and behavioral problems by a technician under the supervision of a physician or other qualified healthcare professional. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 97152?

CPT 97152 can be used to describe the assessment and identification of destructive behavior and behavioral problems by a technician under the direction of a physician or other qualified healthcare professional. This code is used when the technician spends 15 minutes face-to-face with the patient, interacting directly to assess the patient’s behavior and identify specific destructive behaviors or insufficient communication skills.

2. Official Description

The official description of CPT code 97152 is: ‘Behavior identification-supporting assessment, administered by one technician under the direction of a physician or other qualified health care professional, face-to-face with the patient, each 15 minutes.’

3. Procedure

1. A technician, under the guidance of a physician or other qualified healthcare professional, assesses the behavior of the patient by interacting directly with the patient.
2. The technician identifies specific destructive behaviors, such as self-injurious behavior, aggression, or property destruction, as well as insufficient communication skills.
3. The technician assesses the patient on various interactive, language, and social behaviors.
4. Observations are recorded, and additional tests may be used to further assess the patient’s behaviors.
5. The technician spends 15 minutes face-to-face with the patient for each assessment session.
6. The procedure may be repeated on the same or different days until the behavior identification assessment is complete.

4. Qualifying circumstances

CPT 97152 is used when a technician, supervised by a physician or other qualified healthcare professional, provides supporting assessment of a patient’s destructive behavior and behavioral problems. The patient must be assessed face-to-face, and the assessment must be conducted for each 15-minute session. This code is not used for psychiatric diagnostic evaluation, speech evaluations, occupational therapy evaluation, medical team conferences, health and behavior assessment/intervention, neurobehavioral status exams, or neuropsychological testing.

5. When to use CPT code 97152

CPT code 97152 should be used when a technician, under the direction of a physician or other qualified healthcare professional, provides a face-to-face assessment of a patient’s destructive behavior and behavioral problems. This code should be reported for each 15-minute session spent with the patient. It should not be reported with other codes for psychiatric diagnostic evaluation, speech evaluations, occupational therapy evaluation, medical team conferences, health and behavior assessment/intervention, neurobehavioral status exams, or neuropsychological testing.

6. Documentation requirements

To support a claim for CPT 97152, the following documentation is required:

• Record of the patient’s behavior and specific destructive behaviors identified
• Observations and assessments made by the technician during the face-to-face session
• Date, start and end time of each 15-minute session
• Tests or additional assessments used to further evaluate the patient’s behaviors
• Signature of the supervising physician or qualified healthcare professional

7. Billing guidelines

When billing for CPT 97152, ensure that the assessment is conducted by a technician under the direction of a physician or other qualified healthcare professional. The session should be face-to-face with the patient for each 15 minutes. Do not report CPT 97152 with codes for psychiatric diagnostic evaluation, speech evaluations, occupational therapy evaluation, medical team conferences, health and behavior assessment/intervention, neurobehavioral status exams, or neuropsychological testing.

8. Historical information

CPT 97152 was added to the Current Procedural Terminology system on January 1, 2019. There have been no updates to the code since its addition.

9. Examples

1. A technician, under the direction of a physician, assesses a patient’s self-injurious behavior during a 15-minute face-to-face session.
2. A qualified healthcare professional supervises a technician who interacts with a patient to assess their aggression and communication skills in a 15-minute session.
3. A technician, under the guidance of a physician, identifies and records a patient’s property destruction behavior during a 15-minute face-to-face assessment.
4. A qualified healthcare professional oversees a technician who assesses a patient’s insufficient communication skills in a 15-minute session.
5. A technician, under the direction of a physician, interacts with a patient to assess their destructive behavior and records observations during a 15-minute face-to-face session.
6. A qualified healthcare professional supervises a technician who assesses a patient’s behavioral problems and uses tests to further evaluate their behaviors in a 15-minute session.
7. A technician, under the guidance of a physician, identifies and records a patient’s self-injurious behavior during a 15-minute face-to-face assessment.
8. A qualified healthcare professional oversees a technician who interacts with a patient to assess their aggression and communication skills in a 15-minute session.
9. A technician, under the direction of a physician, assesses a patient’s property destruction behavior and records observations during a 15-minute face-to-face session.
10. A qualified healthcare professional supervises a technician who assesses a patient’s insufficient communication skills and uses tests to further evaluate their behaviors in a 15-minute session.