How to bill/ use Add-on Code +90785
+90785 is an add- on code is used for interactive- complexity, used in conjunction with other codes; 90834, 90837. Never to be billed by itself.
Communication complexity is typically
- Have legal guardians responsible for their care, such as minors or adults with guardians
- Request others to be involved in the care during the visit, such as adults accompanied by one or more participating family members or interpretor** or language translator**
- Require the involvement of other third parties, such as child welfare agencies, parole or probation offices or schools
Interactive complexity may be reported with psychiatric procedures when at least one of the following communication difficulties
- The need to manage maladaptive communication a among participants that complicate delivery of care. Example high reactivity or disagreement among family members.
- Caregiver emotions/ behavior that interfere with implementation of the treatment plan
- Evidence/ disclosure of sentinel event and mandated report to a third party with initiation of discussion of the sentinel event and/ or report with patient and other visit participants.
- Use of Play equipment or other physical devices, or an interpreter** or translator,** required because of the patient’s lack of fluency or undeveloped verbal skills.
**The Centers for Medicare and Medicaid Service state that the interactive complexity, 90785 should not be billed solely for the purpose of translation or interpretation services. This could be a violation of Rehabilitation Act of 1973, Americans with Disabilities Act or Title VI of the Civil Rights Act of 1964.
Used in Conjunction with Codes
- Psychiatric Codes: 90791, 90792
- Psychotherapy individual sessions: 90832, 90834, 90837
- Group therapy: 90853
May Not be billed with
Psychotherapy Crisis: 90839, 90840
Documentation
In the notes for session, it is critical to document how and the use of the usage of the add-on code for interactive complexity was used for psychotherapy
Billing Insurance
The add-on code +90785 is an acceptable service code, however, each insurance company has a individual policy on how the code is accepted and reimbursed. Most insurance companies will accept the code and will apply a reimbursement rate. Normally, when an insurance company does not reimburse for the add-on code, they will apply zero payment, $0.00, for this line item. However, they do accept the accompanying service code.
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