Form Phq-9 - Patient Health Questionnaire Modified For Teens Page 2
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3Interpreting the
Depression Severity
Screening Results
The overall score on the PHQ-9 Modified provides information
about the severity of depression, from minimal depression to
severe depression.
Patients that score positive on the questionnaire should be
evaluated by their primary care provider (PCP) to determine if the
The interview with the patient should focus on their answers
depression symptoms they endorsed on the screen are significant,
to the screen and the specific symptoms with which they are
causing impairment and/ or warrant a referral to a mental health
having difficulties.
specialist or follow-up treatment by the PCP.
Additional questions on the PHQ-9 Modified also explore dysthymia,
impairment of depressive symptoms, recent suicide ideation and
It is recommended that the PCP inquire about suicidal
previous suicide attempts.
thoughts and previous suicide attempts with all patients that
score positive, regardless of how they answered these items on
the PHQ-9 Modified.
Total Score: Depression Severity
For patients who score negative on the PHQ-9 Modified, it is
1–4: Minimal depression
recommended that the PCP briefly review the symptoms marked as
5–9: Mild depression
“more than half days” and “nearly every day” with the patient.
10–14: Moderate depression (≥ 11 = Positive Score)
The questionnaire indicates only the likelihood that a youth is at
15–19: Moderately severe depression
risk for depression or suicide; its results are not a diagnosis or a
substitute for a clinical evaluation.
20–27: Severe depression
Engaging and
Coding and Payment
Informing
The following is a comprehensive list of relevant codes that may be used to bill for mental
Parents
health checkups. These codes are not guaranteed to work with all payers.
Mental Health Screening
Inform parents of the screening
96110 – Developmental screening, with interpretation and report, per standardized instrument
results (positive or negative), and
form.
recommendations for referral, treatment or
HCPCS Level II Code G0451 - Developmental testing with interpretation and report, per
follow-up.
standardized instrument form.
Provide parents with information about
the next steps and offer support and
Health Risk Assessment Code
assistance with finding or making an
99420 – This code may be used for the
appointment with a behavioral health
Established Patients New Patients
administration and interpretation of a health
specialist.
risk assessment instrument.
99211 (5 minutes)
99201 (10 minutes)
Give information to parents about why the
referral is being made, how the services
Evaluation and Management Codes (E/M)
99212 (10 minutes)
99202 (20 minutes)
you are referring can help, and details about
PCPs may report an office or outpatient
99213 (15 minutes)
99203 (30 minutes)
where you are sending them.
E/M code using time as the key factor
Compile a list of appropriate referral
when a limited screening test is administered
99214 (25 minutes)
99204 (45 minutes)
resources in the community and share that
along with an E/M service.
99215 (40 minutes)
99205 (60 minutes)
list with families of patients that receive a
Modifier 25
referral.
Modifier 25 tells insurers that the particular
Work with the patient’s existing insurance
For more information about coding and
visit is different; it should be added to the
benefit to determine the referral resources
payment for mental health issues, please
office / outpatient visit to indicate that a
that are available to them.
refer to our Guide to Coding and Payment.
significant, separately identifiable E/M service
Obtain written permission from parents
was performed in addition to the preventive
to allow the transfer of information
medicine visit. Note that many insurers do not reimburse for modifier 25.
between the PCP and the behavioral health
specialist who accepts the referral.
Relevant ICD-9 (Diagnosis) Codes
V20.2 – Well-child, preventative health visits
For more information about making
V79.8 – Special screening exam for mental disorders and developmental handicaps
a referral, please refer to the Guide to
Referral.
V40.0 – Mental and behavioral health problems
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