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Health and behavior assessment codes (96152-96154)

Hello,

I am having a hard time figuring out the correct way to bill these codes. Per the definition, they must used to "bill for services provided to patients who are not diagnosed with a psychiatric problem, but whose cognitive, emotional, social, or behavioral functioning affect prevention, treatment, or management of a physical health problem."

An example given to me was a person who has stomach aches due to their anxiety. I found a resource online from Optum360 that gives a list of diagnostic codes to use with these CPT codes, but they do not make sense to me. I was hoping for some insight from my fellow coders. How do these codes fit under a physical health problem? I do understand that they could have physical health problems due to these issues, but as a standalone issue?

Z59.7 Insufficient social insurance and welfare support
Z60.0 Problems of adjustment to life-cycle transition
Z60.2 Problems related to living alone
Z62.29 Other upbringing away from parents
Z62.891 Sibling rivalry
Z63.0 Problems in relationship with in-laws
Z63.8 Other specified problems related to primary support group
Z64.4 Discord with counselors

Plus many more that fall along those lines.

Thank you!
Erin

Medical Billing and Coding Forum