How To Use CPT Code 90887

CPT 90887 is a code used for the interpretation or explanation of psychiatric and medical examination results to family members or caregivers, providing guidance on patient care. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 90887.

1. What is CPT 90887?

CPT 90887 is a code used by healthcare providers to bill for the service of interpreting and explaining the results of psychiatric and medical examinations, procedures, or accumulated data to the patient’s family members or other responsible persons. This service aims to provide guidance and advice on how to assist the patient in their care and management of their condition.

2. 90887 CPT code description

The official description of CPT code 90887 is: “Interpretation or explanation of results of psychiatric, other medical examinations and procedures, or other accumulated data to family or other responsible persons, or advising them how to assist patient.”

3. Procedure

The 90887 procedure involves the following steps:

  1. The healthcare provider reviews the patient’s psychiatric and medical examination results, procedures, or accumulated data.
  2. The provider interprets and explains the findings to the patient’s family members or caregivers.
  3. The provider offers guidance and advice on how to assist the patient in managing their condition and improving their overall well-being.
  4. The provider may also discuss potential treatment options, medication management, and any necessary lifestyle changes with the family members or caregivers.
  5. Finally, the provider documents the service provided, including the information discussed and any recommendations made.

4. Qualifying circumstances

Patients eligible to receive CPT code 90887 services are those who have undergone psychiatric or medical examinations, procedures, or have accumulated data that requires interpretation and explanation to their family members or caregivers. This service is particularly beneficial for patients with complex or chronic conditions that require ongoing care and support from their family members or caregivers. Examples of such conditions include mental health disorders, chronic illnesses, or developmental disabilities.

5. When to use CPT code 90887

It is appropriate to bill the 90887 CPT code when the healthcare provider has interpreted and explained the results of psychiatric or medical examinations, procedures, or accumulated data to the patient’s family members or caregivers, and provided guidance on how to assist the patient in their care. This service should be billed when the provider has spent a significant amount of time discussing the patient’s condition, treatment options, and management strategies with the family members or caregivers.

6. Documentation requirements

To support a claim for CPT 90887, the healthcare provider must document the following information:

  • The patient’s psychiatric or medical examination results, procedures, or accumulated data that were interpreted and explained.
  • The names and relationships of the family members or caregivers who received the interpretation and explanation.
  • A summary of the information discussed, including the patient’s condition, treatment options, and management strategies.
  • Any guidance or advice provided to the family members or caregivers on how to assist the patient in their care.
  • The date and duration of the service provided.

7. Billing guidelines

When billing for CPT code 90887, healthcare providers should ensure that they have met the documentation requirements and that the service provided is medically necessary and appropriate for the patient’s condition. It is important to note that CPT 90887 should not be reported in conjunction with codes 97151, 97152, 97153, 97154, 97155, 97156, 97157, 97158, 0362T, or 0373T.

8. Historical information

CPT 90887 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 90887

Five similar codes to CPT 90887 and how they differentiate are:

  • CPT 90885: This code is used for a psychiatric evaluation of hospital records, other psychiatric reports, or psychometric and/or projective tests.
  • CPT 90889: This code is for the preparation of a psychiatric report for legal or other non-treatment purposes.
  • CPT 96127: This code is for the administration and scoring of a brief emotional/behavioral assessment.
  • CPT 96130: This code is for psychological testing evaluation services by a physician or other qualified healthcare professional.
  • CPT 96138: This code is for the administration and scoring of psychological tests by a technician.

10. Examples

Here are 10 detailed examples of CPT code 90887 procedures:

  1. A psychiatrist interprets the results of a patient’s psychiatric evaluation and discusses the diagnosis of major depressive disorder with the patient’s spouse, providing guidance on how to support the patient through treatment.
  2. A neurologist explains the results of a patient’s MRI to their adult children, discussing the diagnosis of multiple sclerosis and providing advice on managing symptoms and coordinating care.
  3. A pediatrician reviews the results of a child’s developmental assessment with the child’s parents, explaining the diagnosis of autism spectrum disorder and providing guidance on early intervention services and strategies to support the child’s development.
  4. An oncologist interprets the results of a patient’s biopsy and discusses the diagnosis of breast cancer with the patient’s partner, providing guidance on treatment options and ways to support the patient during treatment.
  5. A geriatrician reviews the results of a patient’s cognitive assessment with the patient’s adult children, explaining the diagnosis of Alzheimer’s disease and providing advice on managing the patient’s care and safety needs.
  6. A cardiologist interprets the results of a patient’s echocardiogram and discusses the diagnosis of congestive heart failure with the patient’s spouse, providing guidance on medication management and lifestyle changes to support the patient’s health.
  7. A pulmonologist explains the results of a patient’s sleep study to their partner, discussing the diagnosis of obstructive sleep apnea and providing advice on the use of a continuous positive airway pressure (CPAP) machine and other strategies to improve sleep quality.
  8. A gastroenterologist reviews the results of a patient’s colonoscopy with the patient’s adult children, explaining the diagnosis of Crohn’s disease and providing guidance on treatment options and ways to support the patient’s nutritional needs.
  9. An endocrinologist interprets the results of a patient’s blood tests and discusses the diagnosis of type 2 diabetes with the patient’s spouse, providing guidance on medication management, blood sugar monitoring, and lifestyle changes to support the patient’s health.
  10. A rheumatologist explains the results of a patient’s joint imaging studies to their adult children, discussing the diagnosis of rheumatoid arthritis and providing advice on managing pain, inflammation, and mobility issues.

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