90834 VS 90847

[mmiele1979]

Question: Mom comes in with son for his psychotherapy appointment. In the notes it says they discussed school and the patient being anxious. There is nothing about family issues or family dynamic. Seems pretty much that they were talking specifically about the son and there is nothing about mom or her interactions with the patient. Mom claims she barely spoke and was only there for emotional support. We billed a 90847. Do the visit notes NEED to justify/explain the family dynamic that is being addressed in order to bill for the 90847 or is it automatically a 90847 just because she was present?

 

[SharonCollachi]

That is not family therapy. That's individual therapy. It is not who is there, it is why they are there.

 

[mmiele1979]

That is not family therapy. That's individual therapy. It is not who is there, it is why they are there.

Do you have a reference for where you understand that to be the case that I can bring to my behavioral health provider? Are you taking this from the CPT guidelines?

 

[SharonCollachi]

It's in the CPT book. "See codes 90846, 90847 when utilizing family psychotherapy techniques, such as focusing on family dynamics." And I back it up with a dozen or so years of mental health billing, where I found this to be consistent with all payer guidelines.

Don't forget the interactive complexity add-on code, 90785, when a parent is present with the child who is the patient.