1. Verify Patient and Order Information
Confirm the patient’s date of birth, demographics, and insurance information are correct in BrainCheck.
Ensure the correct order type (Assess, Care Plan, or Screen) is selected before testing.
2. Use the Correct CPT Codes
96136 – Assess Administration (provider-administered, first 30 min)
96138 – Assess Administration (technician-administered, first 30 min)
96132 – Assess Interpretation (first hour)
99483 – Care Plan (standalone visit, every 180 days)
3. Apply Modifiers When Needed
Use -59 modifier on 96138 and 96132 when billing with an E&M code.
If additional procedures are billed with BrainCheck, apply -25 modifier to the E&M code and -59 modifier to 96138 and 96132.
For telehealth billing:
93 modifier = Audio-only
95 modifier = Audio + video
4. Choose the Correct ICD-10 Codes
Examples:
F02- Dementia
F07.81 Post Concussion Syndrome
F33- Major Depressive Disorder, Recurrent
G20- Parkinson’s Disease
G30- Alzheimer’s Disease
G31.84 Mild Cognitive Impairment
👉 Refer to your Medicare MAC LCD/Billing Article or payer-specific policies for a full list.
5. Double-Check Before Submission
Confirm all required documentation is attached.
Ensure correct modifiers and ICD-10 codes are applied.
Verify provider signature is included.