Hello, I have a couple of counselors providing counseling sessions to children, and they are using art/drawing/ and toys as part of the therapy, is this an appropriate situation to use the 90785 interactive complexity code?
Thank you, so our providers are doing counseling sessions, and using art/toys as methods of showing clients feelings/emotions, this is documented in the notes. They don't use for every client. I guess since these types aren't listed in the code I wasn't sure if they qualified.The use of art/drawing/toys alone does not warrant the use of the 90785. Those things are used to facilitate communication, yes, but the key part is "being used to overcome significant language barriers." So the provider should document the purpose of the activity. If they routinely use it with all children, whether those children will open up and talk or not, then it is not appropriate to bill for every child.
Interactive Complexity (90785) is an add-on code specific for psychiatric services and refers to communication difficulties during the psychiatric procedure. Add-on codes may only be reported in conjunction with other codes, never alone. The specific communication difficulties are present with patients who typically:
1. Have other individuals legally responsible for their care, such as minors or adults with guardians, or
2. Request others to be involved in their care during the visit, such as adults accompanied by one or more participating family members or interpreter or language translator, or
3. Require the involvement of other third parties, such as child welfare agencies, parole or probation officers, or schools.
Interactive complexity may be reported with psychiatric procedures when at least one of the following communication difficulties is present:
1. The need to manage maladaptive communication (related to, e.g., high anxiety, high reactivity, repeated questions, or disagreement) among participants that complicates delivery of care.
2. Caregiver emotions/behavior that interfere with implementation of the treatment plan.
3. Evidence/disclosure of a sentinel event and mandated report to a third party (e.g., abuse or neglect with report to state agency) with initiation of discussion of the sentinel event and/or report with patient and other visit participants.
4. Use of play equipment, physical devices, interpreter or translator to overcome significant language barriers.