Information for Dates of Service Before October 1, 2015

Central Nervous System Assessments and Tests

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.

Computer-Based Testing of Student Athletes for Post-Concussion Syndrome

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).