How To Use CPT Code 90839

CPT 90839 is a code used for psychotherapy for crisis situations, typically lasting between 30 to 74 minutes. This article will cover the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 90839 procedures.

1. What is CPT 90839?

CPT 90839 is a code used to describe psychotherapy services provided to patients in crisis situations. These situations are typically life-threatening and require immediate attention from the provider. The code is used for sessions that last between 30 to 74 minutes, with the primary goal of mobilizing resources to defuse the crisis and restore the patient’s safety, minimizing the potential for psychological trauma.

2. 90839 CPT code description

The official description of CPT code 90839 is: “Psychotherapy for crisis; first 60 minutes.”

3. Procedure

The 90839 procedure involves the following steps:

  1. Assessment of the patient’s crisis situation and immediate needs.
  2. Establishment of a therapeutic relationship with the patient.
  3. Implementation of appropriate psychotherapy techniques to address the crisis.
  4. Mobilization of resources to defuse the crisis and restore the patient’s safety.
  5. Monitoring of the patient’s progress and adjustment of the treatment plan as needed.
  6. Documentation of the session, including the patient’s response to treatment and any changes in the treatment plan.

4. Qualifying circumstances

Patients eligible to receive CPT code 90839 services are those experiencing a life-threatening or complex crisis situation that requires immediate attention. Examples of qualifying circumstances include, but are not limited to:

  • Severe suicidal ideation or behavior
  • Psychotic episodes
  • Severe self-harm or self-destructive behavior
  • Extreme emotional distress related to trauma or loss
  • Acute substance abuse or withdrawal symptoms

5. When to use CPT code 90839

It is appropriate to bill the 90839 CPT code when the provider performs psychotherapy for a patient in a state of crisis, as defined by the qualifying circumstances listed above. The treatment session should last between 30 to 74 minutes, with the primary goal of mobilizing resources to defuse the crisis and restore the patient’s safety.

6. Documentation requirements

To support a claim for CPT 90839, the following information should be documented:

  • The patient’s presenting crisis situation and immediate needs
  • A description of the psychotherapy techniques used during the session
  • The duration of the session, which must be between 30 to 74 minutes
  • The patient’s response to treatment and any changes in the treatment plan
  • Any referrals or additional resources provided to the patient

7. Billing guidelines

When billing for CPT code 90839, keep in mind the following guidelines:

  • CPT 90839 may not be reported more than once per day.
  • For each additional 30 minutes of psychotherapy for crisis, use CPT code 90840.
  • Ensure that the documentation supports the use of CPT 90839, including the duration of the session and the patient’s response to treatment.

8. Historical information

CPT 90839 was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates to the code since its addition.

9. Similar codes to CPT 90839

Five similar codes to CPT 90839 and how they differentiate are:

  1. CPT 90832: This code is used for individual psychotherapy sessions lasting 30 minutes, not specifically for crisis situations.
  2. CPT 90834: This code is used for individual psychotherapy sessions lasting 45 minutes, not specifically for crisis situations.
  3. CPT 90837: This code is used for individual psychotherapy sessions lasting 60 minutes, not specifically for crisis situations.
  4. CPT 90840: This code is used for each additional 30 minutes of psychotherapy for crisis beyond the initial 60 minutes covered by CPT 90839.
  5. CPT 90846: This code is used for family psychotherapy without the patient present, not specifically for crisis situations.

10. Examples

Here are 10 detailed examples of CPT code 90839 procedures:

  1. A patient presents with severe suicidal ideation and a plan to end their life. The provider spends 60 minutes in a crisis intervention session, mobilizing resources to ensure the patient’s safety.
  2. A patient experiencing a psychotic episode is brought to the provider by a family member. The provider spends 45 minutes in a crisis intervention session, using psychotherapy techniques to help stabilize the patient.
  3. A patient with a history of self-harm presents with fresh wounds and extreme emotional distress. The provider spends 50 minutes in a crisis intervention session, addressing the patient’s immediate needs and safety concerns.
  4. A patient in acute alcohol withdrawal presents with severe anxiety and agitation. The provider spends 35 minutes in a crisis intervention session, using psychotherapy techniques to help manage the patient’s symptoms and ensure their safety.
  5. A patient who recently lost a loved one presents with extreme emotional distress and an inability to function. The provider spends 55 minutes in a crisis intervention session, providing support and resources to help the patient cope with their loss.
  6. A patient with a history of severe depression presents with suicidal ideation and a plan to end their life. The provider spends 65 minutes in a crisis intervention session, using CPT 90839 for the first 60 minutes and CPT 90840 for the additional 5 minutes.
  7. A patient experiencing a manic episode presents with impulsive and dangerous behavior. The provider spends 40 minutes in a crisis intervention session, using psychotherapy techniques to help stabilize the patient and ensure their safety.
  8. A patient with a history of trauma presents with flashbacks and extreme emotional distress. The provider spends 70 minutes in a crisis intervention session, using CPT 90839 for the first 60 minutes and CPT 90840 for the additional 10 minutes.
  9. A patient with a history of substance abuse presents with acute withdrawal symptoms and severe anxiety. The provider spends 30 minutes in a crisis intervention session, addressing the patient’s immediate needs and safety concerns.
  10. A patient with a history of severe anxiety presents with a panic attack and difficulty breathing. The provider spends 50 minutes in a crisis intervention session, using psychotherapy techniques to help manage the patient’s symptoms and ensure their safety.

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