Neuropsych Question?

[PsychEval]

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When listing a diagnosis, where do neuropsychologists place the patient’s TBI? Is this listed on axis III? If the pt has a FSIQ - 70 or below, has impairments in adaptive functioning, and the onset of the impairment began after: age 18 and the TBI, what is placed on Axis II?

 

[JatPenn]

When listing a diagnosis, where do neuropsychologists place the patient’s TBI? Is this listed on axis III? If the pt has a FSIQ - 70 or below, has impairments in adaptive functioning, and the onset of the impairment began after: age 18 and the TBI, what is placed on Axis II?

If there is no indication of a personality disorder and the person does not quality for MR (after age 18), I would say that there would be no Axis II Dx in this case.

 

[PsychEval]

If there is no indication of a personality disorder and the person does not quality for MR (after age 18), I would say that there would be no Axis II Dx in this case.

I see. So a pt could have a FSIQ - 40, but not be diagnosed with MR, correct?

 

[JatPenn]

Right, if onset of symptomatology is after age 18, you can't make an MR dx.

 

[PsychEval]

Thanks.

 

[Neuro-Dr]

I would put Dementia secodary to Head Injury - if that was the cause and you estimate a drop in IQ of 15 point or more on axis I and TBI on Axis III

 

[PsychEval]

I would put Dementia secodary to Head Injury - if that was the cause and you estimate a drop in IQ of 15 point or more on axis I and TBI on Axis III

Interesting, I will look into that. In this case, would the neuropsychologist bill under Axis I or Axis III?

 

[Neuro-Dr]

Interesting, I will look into that. In this case, would the neuropsychologist bill under Axis I or Axis III?

You would bill the 294 Dementia code on Axis I. The TBI may be the cause, but the dementia was the reason for testing.

 

[PsychEval]

Thanks. I have heard neuropsychologists typically bill under the medical plan, and not the mental health carve out, is this true?

 

[Neuro-Dr]

Thanks. I have heard neuropsychologists typically bill under the medical plan, and not the mental health carve out, is this true?

yes, the code billed depends on the indication. If a patient came for ADHD, I would bill psych, for stroke - medical