Psychiatry Coding & Reimbursement Alert

Published on Fri Jan 06, 2017 PDF

Question: Our psychiatrist recently had a lengthy session with family members of a patient. He said that he had to spend more time with the family as he was having difficulty in communication with the siblings of the patient. If our clinician had some difficulty in communication with family members, can interactive complexity add-on code, +90785 be reported with family therapy codes?

Colorado Subscriber

Answer: You should not report +90785 (Interactive complexity [List separately in addition to the code for primary procedure]) with either of the family psychotherapy codes, 90846 (Family psychotherapy [without the patient present], 50 minutes) or 90847 (Family psychotherapy [conjoint psychotherapy] [with patient present], 50 minutes).

According to CPT^®, common factors associated with interactive complexity include more difficult communication with discordant or emotional family members and engagement of young and verbally undeveloped or impaired patients. CPT^® also says that typical patients requiring interactive complexity are those who have third parties, such as parents, guardians, or other family members, involved in their psychiatric care.

Going by this, you can consider the interactive complexity component as inherent to the family psychotherapy codes and you cannot separately report it by using a code such as +90785. Further, parenthetical instructions following +90785 in CPT^® state that it should be used in conjunction with codes for diagnostic psychiatric evaluation [90791, 90792], individual psychotherapy [90832-90838], and group psychotherapy [90853]. The family psychotherapy codes are not among this list.