Interactive Complexity and Prolonged Services

[Merrylb]

If a psychotherapy appointment calls for an interactive complexity add-on and the appointment met the time requirements to use the prolonged services add-on (90-120 minutes), could we use both add-ons? Or would this be considered upcoding?

Any help or advice is greatly appreciated!

Merryl Blatnik, CPC, CH-CBS
Medical Coding Specialist

 

[JRae5M]

When performed with psychotherapy, the Interactive Complexity component (90785) relates only to the increased work intensity of the psychotherapy service, and does not change the time for the psychotherapy service. Per WPS, documentation needs to support the medical necessity for the extended psychotherapy time.

 

[khollinger]

Yes as long as the time spent with the client qualifies for a prolonged visit code(99354/99355) you can use both interactive complexity and prolonged visit on the same encounter.

 

[tworottstown]

Does anyone know if a psychologist or social worker (clinical licensed) can code for the prolonged service when providing 90 minutes of therapy?

 

[msbernards]

Does anyone know if a psychologist or social worker (clinical licensed) can code for the prolonged service when providing 90 minutes of therapy?

Yes, both of those licensures can bill for prolonged.