Providers may submit claims with up to six units of any combination of central nervous system assessments and tests for one DOS. Computer-based testing of student athletes for post-concussion syndrome is excluded from this limit.
Wisconsin Medicaid reimburses physicians, physician assistants, and nurse practitioners for computer-based neuropsychological post-concussion testing of student athletes. The rendering provider must be trained to correctly interpret the test.
The computer-based neuropsychological post-concussion test should be compared with a computer-based pre-concussion baseline test administered by the student's athletic organization before the injury occurred. The administration of a pre-concussion baseline test is not reimbursable.
On claims for computer-based neuropsychological post-concussion testing of student athletes, providers should indicate CPT procedure code 96120 (Neuropsychological testing [eg, Wisconsin Card Sorting Test], administered by a computer, with qualified health care professional interpretation and report). The allowable ICD-9-CM diagnosis codes for computer-based neuropsychological post-concussion testing of student athletes are 310.2 (Postconcussion syndrome) or 850.0-850.9 (Concussion).