AMA CPT® Assistant - 2016 Issue 11 (November)
New Codes for Health-Risk Assessments (96160, 96161) (November 2016)
November 2016 page 5 New Codes for Health-Risk Assessments ( 96160 , 96161 ) For CPT ® 2017, two new codes ( 96160 and 96161 ) have been created to replace code 99420 . Code 99420 was previously used to report the administration and interpretation of a health-risk assessment. However, assessment of the patient's caregiver for the benefit of the patient is also an important service, which was not captured in the previous code. To address this, beginning in 2017, new codes 96160 and 96161 will distinguish between the focus of the assessment: the patient and the caregiver. In addition, the...
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Article Overview
This article explains a CPT 2017 update involving health-risk assessment services and related preventive medicine reporting. It is intended for coders, billers, and clinical documentation staff who need to understand the scope of the new assessment codes, the shift in their placement within CPT, and the surrounding guidance that affects reporting in the context of evaluation and management and preventive services.
Why This Topic Matters
These changes affect how health-risk assessment services are identified and documented in CPT, including distinctions between patient-focused and caregiver-focused assessments. The article also highlights related guidance that may influence reporting alongside preventive medicine and evaluation and management services.
Article Sections
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Medicine
This section places the assessment services within the Medicine portion of CPT and identifies the relevant assessment category.
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Health and Behavior Assessment/Intervention
This section presents the assessment services associated with standardized instruments and documentation requirements.
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Evaluation and Management
This section identifies where related preventive medicine and counseling/risk-factor reduction content appears within CPT.
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Preventive Medicine Services
This section situates the discussion in the preventive medicine area and links it to broader reporting context.
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Counseling Risk Factor Reduction and Behavior Change Intervention
This section covers the counseling/risk-factor reduction subsection relevant to related screening and intervention reporting.
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New or Established Patient — Behavior Change Interventions, Individual
This section identifies the patient type and intervention category used in the surrounding preventive medicine framework.
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Clinical Example (96161) / Description of Procedure (96161)
This section pairs a clinical example with a procedure description for the caregiver-focused assessment service.
What You Will Learn
- How the article frames CPT updates for health-risk assessment reporting
- How the new assessment services are organized within CPT
- How the article discusses the relationship between these services and preventive medicine reporting
- What documentation and reporting context the article addresses for patient and caregiver-focused assessments
Who Should Read This
- Medical coders
- Billing professionals
- Compliance staff
- Clinical documentation specialists
- Physicians and other qualified health care professionals
Codes Discussed
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