Basics of 90791 & 90792 CPT code
Psychiatric diagnostic evaluation is an integrated biopsychosocial assessment, including history, mental status, and recommendations. The evaluation may include communication with family or other sources and review and ordering of diagnostic studies.
Psychiatric diagnostic evaluation with medical services is an integrated biopsychosocial and medical assessment, including history, mental status, other physical examination elements as indicated, and recommendations. The evaluation may include communication with family or other sources, prescription of medications, and review and ordering of laboratory or other diagnostic studies. 90791 CPT code is one of the procedure code for Psychiatric diagnostic evaluation. Description of 90791 and 90792 CPT code
CPT code 90791 reports a psychiatric diagnostic interview exam including a complete medical and psychiatric history, a mental status exam, ordering of laboratory and other diagnostic studies with interpretation, and communication with other sources or informants. The psychiatrist then establishes a tentative diagnosis and determines the patient’s capacity to benefit from psychotherapy treatment. The patient’s condition will determine the extent of the mental status exam needed during the diagnostic interview.
In determining mental status, the doctor looks for symptoms of psychopathology in appearance, attitude, behavior, speech, stream of talk, emotional reactions, mood, and content of thoughts, perceptions, and sometimes cognition. The diagnostic interview exam is done when the provider first sees a patient, but may also be utilized again for a new episode of illness, or for re-admission as an inpatient due to underlying complications. When a psychiatric diagnostic evaluation is performed alone, report CPT code 90791. When medical services are provided in conjunction with the psychiatric diagnostic evaluation, report CPT code 90792.
90791 – Psychiatric diagnostic evaluation
90792 – Psychiatric diagnostic evaluation with medical services
Coding tips for 90791 and 90792 CPT code
- Do not report 90791 or 90792 in conjunction with 99202-99316, 99341-99350, 99366-99368, 99401-99443, 97151, 97152, 97153, 97154, 97155, 97156, 97157, 97158, 0362T, 0373T
Use CPT code 90785 in conjunction with 90791, 90792 when the diagnostic evaluation includes interactive complexity services - If the psychiatric diagnostic evaluation is performed using audio-only technology, then modifier 93 would be appended to code 90791
- CPT Code 90791 & 90792 may be reported once per day and not on the same day as an evaluation and management service performed by the same individual for the same patient.
RVU and Fees for 90791 CPT code
| Non-Facility | Work | MP | PE | RVU | Total |
|---|
| 3.84 | 0.10 | 1.22 | 5.16 | $174.86 |
| Facility | Work | MP | PE | RVU | Total |
|---|
| 3.84 | 0.10 | 0.51 | 4.45 | $150.80 |
RVU and Fees for 90792 CPT code
| Non-Facility | Work | MP | PE | RVU | Total |
|---|
| 4.16 | 0.18 | 1.46 | 5.80 | $196.55 |
| Facility | Work | MP | PE | RVU | Total |
|---|
| 4.16 | 0.18 | 0.74 | 5.08 | $172.15 |
PC/TC Indicator (26): 0 = Physician Service Codes
Multiple Procedures (51): 0 = No payment adjustment rules for multiple procedures apply
Bilateral Surgery (50): 0 = 150% payment adjustment for bilateral procedures does not apply
Physician Supervision: 09 = Concept does not apply
Assistant Surgeon (80,82): 9 = Concept does not apply
Co-Surgeons (62): 0 = Co-surgeons not permitted for this procedure
Team Surgery (66): 0 = Team surgeons not permitted for this procedure
Diagnostic Imaging Family: 99 = Concept does not apply
Quality Measures for 90791 & 90792 CPT code
128 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
134 Preventive Care and Screening: Screening for Depression and Follow-Up Plan
181 Elder Maltreatment Screen and Follow-Up Plan
226 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
317 Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
130 Documentation of Current Medications in the Medical Record
282 Dementia: Functional Status Assessment
283 Dementia Associated Behavioral and Psychiatric Symptoms Screening and Management
286 Dementia: Safety Concern Screening and Follow-Up for Patients with Dementia
288 Dementia: Education and Support of Caregivers for Patients with Dementia
370 Depression Remission at Twelve Months
383 Adherence to Antipsychotic Medications For Individuals with Schizophrenia
402 Tobacco Use and Help with Quitting Among Adolescents
431 Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
487 Screening for Social Drivers of Health
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