•• I •11MOLINA

HEALTHCARE

25 de julio de 201 7

A: TODOS LOS PROVEEDORES PARTICIPANTES DEL PLAN DE SALUD DEL GOBIERNO DE MOLINA HEALTHCARE OF PUERTO RICO

RE: CODIGOS DE FACTURACION DIRIGIDOS AL CERNIMIENTO DE CRECIMIENTO Y DESARROLLO Y SALUD CONDUCTUAL

En el Plan de Salud del Gobiemo de Molina Healthcare of Puerto Rico (MHPR) estamos comprometidos en asegurar la calidad en el cuidado de la salud a nuestros beneficiarios, asi como con el servicio a nuestros proveedores participantes.

A partir del 1 de julio de 2017, los servicios de Salud Mental estaran bajo la direcci6n del Departamento de Salud Conductual de MHPR. Como parte del proceso, hemos preparado una guia de Cemimientos de condiciones de salud mental y etapas del desarrollo dirigido a c6digos de facturaci6n. El prop6sito es proveerles una herramienta y facilitar la comunicaci6n entre los proveedores y MHPR a traves de la codificaci6n de estas pruebas. Estas codificaciones van dirigidas a los servicios de Medicina Preventiva, Evaluaci6n y Manejo (E/M) y/o Procedimientos.

El uso de los c6digos nos ayudara a identificar con mas exactitud los diferentes Cemimientos de Salud Conductual y segun las etapas del desarrollo humano. Si tiene dudas o preguntas puede comunicarse a la linea de Servicio al Proveedor al 1-(888) 558-5501 de lunes a viemes de 7:00AM a 7:00 PM.

Cordialmente;

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•11MOLINA' 'I HEALTHCARE OJ f'Ui:lro 11 ( 0 l hl C

Abbreviation

ASQ

ASQ:SE

BASC-2

-- _..... -­BYl-11

CAGE/CRAFFT/DAST­20/AUDIT

: DDST-11

· GAD

l M-CHAT

' : N/A

; N/A

PEDS

PC-PTSD-5

SCARED

-PHQ-9

CPT Codes for Behavioral Assessments

Assessments Description ...__

Ages and Stages Identify children at early ages that Questionnaire - 3rd Edition could be in risk of behavioral delay

Ages and Stages Social or Emotional Development ­Questionnaire - Auto regulation, conformity, Social/Emotional communication, autonomy, affect,

adaptive behavior

Behavior Assessment Scale for Monitor change in behavior or Children 2nd Edition emotional state

Beck Youth Inventories 2nd Evaluates the emotional and social Edition deterioration of children and

adolescents Substance and Alcohol Abuse Detection of use and abuse of drugs Screening and alcohol

Denver II Evaluate behaviors according to chronological age. Prevents future risks in psychomotor development

General Anxiety Disorder Detection and Measurement of Severity of Generalized Anxiety Disorder

Modified Checklist for Autism Identifies autism at an early age in Toddlers

Kutcher Adolescent Identifies and diagnoses depression Depression Scale in adolescents

Vanderbilt Rating Scales Attention-deficit hyperactivity disorder (ADHD)

Parents Evaluation of A method to help parents identify Developmental Status developmental and behavioral

problems in children 1Pediatric Symptom Checklist Evaluate cognitive, emotional, and

behavioral problems

Primary Care PTSD for DSM-5 Designed to identify likely PTSD: identifies exposure to traumatic events

Screen for Child Anxiety How to Identify Different Anxiety Related Disorders Disorders

Patient Health Questionnaire Patient with an initial PHQ-9 score greater than nine who achieves remission at twelve months as demonstrated by a twelve month (+/- 30 days) PHQ-9 score of less than five

CPT Code

96127-Hl

96127-Hl

96127-HG

96127-HG

96127-H2

96127-HG

96127-H3

96127-H4

96127-HG

96127-HG

96127-HG

96127-HG

96127-HS

96127-HG

~

G9393 i

!

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·~·MOLINA~ I• HEALTHCARE OJ J'UlllO ~ICC l hi C

PHQ-9 Patient Health Questionnaire Patient with an initial PHQ-9 score greater than nine who did not achieve remission at twelve months as demonstrated by a twelve month

1 (+/- 30 days) PHQ-9 score of greater than or equal to five

PHQ-9 Patient Health Questionnaire Patient with an initial PHQ-9 score greater than nine (9) who was not assessed for remission at twelve (12) months (+/- 30 days)

PHQ-9 Patient Health Questionnaire Remission at twelve months as demonstrated by a twelve (12) month(+/- 30 days) PHQ-9 score of less than five

PHQ-9 Patient Health Questionnaire Remission at twelve (12) months I 1

not demonstrated by a twelve month (+/-30 days) phq-9 score of less than five; either phq-9 score was not assessed or is greater than or equal to 5

--J.

PHQ-9 Patient Health Questionnaire Index Date PHQ-9 score greater than 1 9 documented during the twelve

(12) month denominator I id~ntification eeriod

PHQ-9 1

Patient Health Questio~naire Remission at six months as demonstrated by a six (6) month (+/- 30 days) PHQ-9 score of less than five

-PHQ-9 Patient Health Questionnaire Remission at six (6) months not

demonstrated by a six month(+/- 30

1 days) PHQ-9 score of less than five: either PHQ-9 score was not assessed or is greater than or equal to five

1

G9395

G9396

G9509

G9510

G9511

G9573

G9574