90885 CPT Code - Psychiatric Evaluation of Records

What is CPT Code 90885

CPT Code 90885 refers to the evaluation of psychiatric records for diagnostic purposes. This code is used by mental health providers to assess prior evaluations, treatment decisions, and other pertinent records that inform the clinician about the patient’s mental health history. This evaluation is crucial for making informed decisions about current and future treatments.

This code does not involve direct patient interaction; rather, it focuses on the analysis of existing records. It provides insights that aid in forming a comprehensive understanding of the patient's mental health state, potential diagnoses, and appropriate treatment recommendations.

Services Covered Under CPT Code 90885

This code encompasses various services related to the psychiatric evaluation of records. The following table details the specific services that fall under this code.

Who Can Use the 90885 CPT Code?

This code is designated for qualified professionals involved in mental health care. Here are the roles eligible to utilize CPT Code 90885:

• Psychiatrists: Medical doctors specializing in mental health can assess records for diagnoses or treatment adjustments.
• Clinical Psychologists: They conduct evaluations to inform therapy methods based on record analysis.
• Licensed Clinical Social Workers: They may use the code while conducting assessments for community or inpatient therapy needs.

How to Use CPT Code 90885

Using CPT Code 90885 requires clarity in documentation and a well‑defined process. Here are the steps to ensure proper use:

• Document the Purpose: Clearly state the necessity for evaluating records. For example, "Reviewing patient history to assess prior trauma treatment outcomes."
• Finish with Detailed Notes: Add specific findings from the record evaluation. For instance, "The patient’s previous diagnoses of depression and efficacy of SSRIs will guide the new treatment plan."
• Link to Current Symptoms: Connect findings to present symptoms articulated by the patient. For example, "Notable discrepancies in reported anxiety levels suggest reevaluation of medication."

Reimbursement Rates for CPT Code 90885

The reimbursement rates for CPT Code 90885 can vary between private insurance and public programs like Medicare. Below is a comparison table.

Disclaimer: Reimbursement rates can frequently change based on multiple variables including location and payer policies. This article is updated regularly to reflect average prices.

Benefits of CPT Code 90885

Understanding the benefits of this code can help clinicians streamline their processes and improve patient care. The benefits are outlined in the table below.

Common Mistakes to Avoid with CPT Code 90885

Mishandling CPT Code 90885 can lead to denials or audits, affecting both providers and patients negatively. Below are common mistakes that can occur:

• Inadequate Documentation: Failing to provide thorough notes on record evaluations can jeopardize reimbursement. For example, a psychiatrist may neglect to note specific data points leading to potential confusion regarding diagnostic decisions.
• Not Justifying the Need: If justification for the evaluation is missing, claims may be denied. An example could be a therapist billing for record evaluations without documenting prior treatment relevance.
• Using Wrong Code Variations: Confusing CPT Code 90885 with similar codes may lead to billing errors. For instance, a psychologist mistakenly using a therapy code instead could incur audits.

CPT Code 90885 vs Other Codes

Comparing CPT Code 90885 with similar codes illustrates nuanced distinctions. The following table highlights key differences:

Conclusion

CPT Code 90885 serves an essential role in mental health assessments by enabling licensed professionals to conduct evaluations of existing records for diagnostic purposes. Proper understanding and execution of this code can significantly enhance the quality of patient care and ensure appropriate reimbursements. Staying informed on best practices and common pitfalls can help mental health providers optimize their documentation processes and avoid potential compliance issues.

Disclaimer: This article is for informational purposes only and does not constitute legal or medical advice. Always consult professional guidelines and regulatory bodies for specific compliance requirements.