96110 Usage Among Pediatricians

The 96110 CPT code…now properly included in AAP preventive care protocols, thanks to Bright Futures. Many practices have performed the screening tests for years, but only few pediatricians actually bill for it. I’ve seen a lot of folks ask about billing for these important parts of preventive visits, so I thought I’d gather some quick data and helpful advice.

First, the advice. Check out this amazing site and its list of excellent 96110 FAQs [now removed…sad] and their answers. Awesome stuff from the AAP. I’m going to do some more fishing in here.
There’s also this excellent piece from Medical Newswire that goes through each of the services expected from the Bright Futures protocols and how to bill for them. These are two of the best on-line references I’ve seen in a long time…and I didn’t even know that Drs. Tuck and Lessin would be quoted in them, promise!

And, when in doubt, check out the AAP’s Medical Home Info WWW site – they have excellent documentation about the use of the 96110 code [updated again – the AAP keeps moving things and hiding them behind paywalls].
Now, for the eye candy:

96110-1

Click (or here) on the pic for a better view.
Tight to read, I know, but here’s what it tells us: since 2003 (when I believe the definition was last updated), PCC customer usage of the 96110 code has gone from 4% of our clients to 29%. At the same time, those clients who do use it, have increased their volume from an annual average of 301 to almost 2000!
Tomorrow, I’ll post the $$. It’s any interesting story. Obviously, though, if our clients weren’t getting paid for it, they wouldn’t be using it. [2008 is projected usage, btw.] Bottom line: what are you remaining 70% waiting for?!
Check out the new poll on the left.

One thought on “96110 Usage Among Pediatricians

  1. Pingback: 96110 Reimbursement Followup | Confessions of a Pediatric Practice Management Consultant

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