Psychiatry Coding & Reimbursement Alert

Question: Our psychiatrist recently performed crisis intervention for a patient who suddenly turned violent. He performed the crisis intervention in three separate sessions on the same calendar date of service. The first session was for 35 minutes; the second was for 30 minutes, and the last was for a total of 35 minutes. Should I report 90839 for each of the sessions, or should I collate the time and report it accordingly?

New Hampshire Subscriber

Answer: When reporting crisis intervention, you report it with the following two codes:

• 90839 (Psychotherapy for crisis; first 60 minutes)
• +90840 (Psychotherapy for crisis; each additional 30 minutes [List separately in addition to code for primary service]).

You will have to use CPT^® time rules to determine the number of units you will report for the crisis psychotherapeutic intervention. According to these rules, you will have to use 90839 for the first 30-74 minutes of face-to-face service provided to the patient. Even though the descriptor for 90839 mentions time as first 60 minutes of service, you will use the same code even if your clinician provides a service that is more than 60 minutes but equal to or less than 74 minutes.

When the session lasts for duration more than 74 minutes but less than 104 minutes, you will have to use the add-on code +90840 in addition to reporting 90839 for the first 74 minutes. When time crosses 105 minutes, you will use 90839 and +90840x2.

The psychotherapy for crisis code 90839 can only be used once per day. The face-to-face time spent providing services to the patient need not be continuous. So, even though your psychiatrist provided the service in more than one session on the same calendar date of service, you have to collate the time that your clinician spent face-to-face with the patient.

So, in this case, your clinician spent a total of 100 minutes performing the crisis intervention. Thus, you will have to report 90839 for the first 74 minutes and report one unit of +90840 for the remaining 26 minutes of service.