ICD-9 Codes that Support Medical Necessity for

ICD-9 Codes that Support Medical Necessity for

ICD-9 Codes that Support Medical Necessity for Neuropsychological testing (96118, 96119 and
96120) is
covered when performed for the following diagnoses/conditions (Survey of six carriers):
307.42 Persistent disorder of initiating or maintaining sleep
307.44 Persistent disorders of initiating or maintaining wakefulness
307.46 Sleep arousal disorder
307.50- 307.54 Other and unspecified disorders of eating
307.59 Other disorders of eating
307.80 Psychogenic pain, site unspecified
307.89 Other, pain disorder related to psychological factors
308.3 Acute reaction to stress
309.0 Adjustment disorder with depressed mood
309.1 Adjustment reaction with prolonged depressive reaction
309.21 Separation anxiety disorder
309.23 Specific academic or work inhibition
309.24 Adjustment disorder with anxiety
309.28 Adjustment disorder with mixed anxiety and depressed mood
309.3 Adjustment disorder, with disturbance of conduct
309.4 Adjustment disorder, with mixed disturbance of emotions and conduct
309.81 Posttraumatic stress disorder
310.1 Personality change due to conditions classified elsewhere
310.8 Other specified nonpsychotic mental disorders following organic brain damage
311 Depressive disorder, NOS
312.81 Conduct disorder, childhood onset type
312.82 Conduct disorder, adolescent onset type
312.89 Other conduct disorder
313.23 Selective mutism
313.81 Oppositional defiant disorder
313.82 Identity disorder
314.00 Attention deficit disorder of childhood without mention of hyperactivit
314.01 Attention deficit disorder of childhood with hyperactivity
314.1 Hyperkinesis of childhood with developmental delay
314.2 Hyperkinetic conduct disorder of childhood
314.8 Other specified manifestations of hyperkinetic syndrome of childhood
314.9 Unspecified hyperkinetic syndrome of childhood
315.00- 315.02 Specific delays in development
315.09 Specific delays in development, other
315.1 Mathematics disorder
315.2 Other specific developmental learning difficulties
315.31 Expressive language disorder
315.32 Mixed receptive-expressive language disorder
315.39 Other developmental speech disorder
315.4 Developmental coordination disorder
315.5 Mixed development disorder
315.8 Other specified delays in development
315.9 Unspecified delay in development
316 – 319 Other mental disorders
317 Mild mental retardation
318.0 Moderate mental retardation
318.1 Severe mental retardation
327.02 Insomnia due to mental disorder
327.15 Hypersomnia due to mental disorder
327.42–327.43 Organic parasomnia
330.0 - 331.9 Cerebral degeneration
12
331.0 Alzheimer’s disease
331.2 Senile degeneration of brain
331.83 Mild cognitive impairment
332.0 - 332.1 Parkinson's disease
333.1 Essential and other specified forms of tremor
333.71–333.72 Acquired torsion dystonia
333.79 Other acquired torsion dystonia
333.82 Orofacial dyskinesia
333.85 Subacute dyskinesiadue to drugs
333.90 Unspecified extrapyramidal disease and abnormal movement disorder
333.92 Neuroleptic malignant syndrome
333.99 Other unspecified extrapyramidal disease and abnormal movement disorder (neurolepticinduced
acute akathisia)
340 Multiple sclerosis
345.00 - 345.91 Epilepsy
348.0 - 348.9 Other conditions of brain
348.1 Anoxic brain damage
348.30-348.39 Encephalopathy; not elsewhere classified
349.82 Toxic encephalopathy
433.00 - 438.9 Occlusion and stenosis precerebral arteries, occlusion ofcerebral arteries, transient
cerebral ischemia, acute, but illdefined; cerebrovascular disease, other and ill-defined
cerebrovascular disease, and late effects of cerebrovascular disease
438.0 Late effects of cerebrovascular disease, cognitive deficits
741.00 - 741.03 Spina bifida with hydrocephalus
742.0 - 742.7 Congenital hydrocephalus
758.0 - 758.9 Chromosomal anomalies
780.97 Altered mental status
780.96 Generalized pain
780.09 Alteration of consciousness, other
780.97 Altered mental status
781.8 Neurolgic neglect syndrome
784.3 Aphasia
784.5 Other speech disturbance
784.60–784.61 Other symbolic dysfunction
784.69 Other symbolic dysfunction
800.00 - 804.99 Fracture of skull
850.0 - 854.19 Intracranial injury
905.0 Late effect of fracture of skull and face bones
907.0 Late effect of intracranial injury without mention of skull fracture
959.01 Head injury, unspecified
963.8 Poisoning by heavy metal anti-infectives
983.0-985.9 Toxic effects; of corrosive aromatics, lead, other metals
997.01 Central nervous system complication
042 Human immunodeficiency virus (HIV) infection; symptomatic
090.40 Juvenile neurosyphilis, unspecified
094.1 General paresis
191.0-191.9 Malignant neoplasm of brain; primary
192.0-192.1 Malignant neoplasm of other/unspecified parts of nervous system; cranial
nerves, cerebral meninges
191.9 Malignant neoplasm of brain, unspecified
198.3 Secondary malignant neoplasm of brain and spinal cord
225.0 Benign neoplasm of brain
237.5 Neoplasm of uncertain behavior of brain and spinal cord
239.6 Neoplasm of unspecified nature of brain
290.0 Senile dementia, uncomplicated
13
290.11- 290.13 Presenile dementia
290.20- 290.21 Senile dementia with delusion or depressive features
290.3 Senile dementia with delirium
290.40 Vascular dementia, uncomplicated
290.41- 290.43 Vascular dementia
291.1 Alcohol-induced persisting amnestic disorder
291.5 Alcohol-induced psychotic disorder with delusions
291.81 Alcohol withdrawal
291.9 Unspecified alcohol-induced mental disorders
292.0 Drug withdrawal
292.11 Drug-induced psychotic disorder with delusions
292.82 Drug-induced persisting dementia
292.83 Drug-induced persisting amnestic disorder
292.84 Drug-induced mood disorder
292.89 Other specified drug induced mental disorders
292.9 Unspecified drug-induced mental disorders
293.0 Delirium due to conditions classified elsewhere
293.81 Psychotic disorder with delusions in conditions classified elsewhere
293.82 Psychotic disorder with hallucinations in conditions classified elsewhere
293.83 Mood disorder in conditions classified elsewhere
293.84 Anxiety disorder in conditions classified elsewhere
293.89 Other specified transient mental disorders due to conditions classified elsewhere, other
293.9 Unspecified transient mental disorder in conditions classified elsewhere
294.0 Amnestic disorder in conditions classified elsewhere
294.10 Dementia in condition classified elsewhere without behavioral disturbance
294.11 Dementia in condition classified elsewhere with behavioral disturbance
294.8 Other persistent mental disorders due to conditions classified elsewhere
294.9 Unspecified persistent mental disorders due to conditions classified elsewhere
296.03 Bipolar I disorder, single manic episode, severe without mention of psychotic behavior
296.04 Bipolar I disorder, single manic episode, severe, specified as with psychotic behavior
296.13 Manic disorder, recurrent episode, severe degree, without mention of psychotic behavior
296.14 Manic disorder, recurrent episode, severe degree, specified as with psychotic behavior
296.23 Major depressive disorder, single episode, severe degree, without mention of psychotic
behavior
296.24 Major depressive disorder, single episode, severe degree, specified as with psychotic
behavior
296.33 Major depressive disorder, recurrent episode, severe degree, without mention of psychotic
behavior
296.34 Major depressive disorder, recurrent episode, severe degree, specified as with psychotic