How To Use CPT Code 90845

CPT 90845 describes the practice of psychoanalysis, a technique used by trained and credentialed providers to help patients gain insight into their unconscious motivations and conflicts. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 90845?

CPT 90845 refers to the practice of psychoanalysis, a therapeutic approach that aims to bring about change in a patient’s maladaptive actions by uncovering the unconscious meanings and motivations behind them. This code is used by trained and credentialed providers, such as physicians or licensed psychologists, who use various techniques to help patients understand and modify their behaviors, feelings, and thoughts.

2. Official Description

The official description of CPT code 90845 is: ‘The provider uses an analytical technique to increase insight into a person’s unconscious motivations and conflicts to effect a change in maladaptive actions.’

3. Procedure

1. During psychoanalysis sessions, the provider reviews relevant medical, legal, and administrative documentation to gain a comprehensive understanding of the patient’s background.
2. The provider arranges appointments as necessary to establish a trusting relationship with the patient, which is crucial for the success of psychoanalysis.
3. The provider attentively listens to and observes the patient, aiming to gain insight into their mental processes and experiences.
4. Using analytical techniques, the provider engages in questioning and patient feedback to facilitate the patient’s introspection and self-understanding.
5. Therapy sessions typically occur between one and four times a week, allowing for ongoing monitoring and reassessment of any medications.

4. Qualifying circumstances

CPT 90845 is used when a trained and credentialed provider conducts psychoanalysis sessions to help patients with maladaptive actions. The provider must have the necessary qualifications, such as being a physician or licensed psychologist. The patient’s condition must warrant the use of psychoanalysis, and the provider must use their expertise to uncover the unconscious motivations and conflicts underlying the patient’s behaviors, feelings, and thoughts.

5. When to use CPT code 90845

CPT code 90845 should be used when a trained and credentialed provider conducts psychoanalysis sessions to effect a change in maladaptive actions. It is important to note that this code should not be confused with psychotherapy codes, such as 90832 to 90838, or other codes related to psychoanalysis, such as 90846 to 90853. Psychoanalysis sessions are typically conducted on a daily basis, ranging from one to four times a week.

6. Documentation requirements

To support a claim for CPT 90845, the provider must document the following information:

• The patient’s diagnosis and the need for psychoanalysis
• The techniques and approaches used during the sessions
• The frequency and duration of the therapy sessions
• Any medications prescribed or monitored during the course of psychoanalysis
• Progress made by the patient and any adjustments to the treatment plan
• The provider’s signature

7. Billing guidelines

When billing for CPT 90845, ensure that the provider conducting the psychoanalysis sessions is qualified and credentialed. It is important to follow the specific guidelines for reporting this code and to avoid confusion with other related codes. Psychoanalysis sessions should be reported per day and should not be reported with other psychotherapy codes. Pay attention to any additional tips provided by coding authorities to ensure accurate billing.

8. Historical information

CPT 90845 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A licensed psychologist conducting psychoanalysis sessions to help a patient overcome deep-rooted fears and anxieties.
2. A psychiatrist using psychoanalysis techniques to uncover the unconscious motivations behind a patient’s self-destructive behaviors.
3. A trained psychoanalyst working with a patient to explore unresolved childhood traumas and their impact on current relationships.
4. A physician using psychoanalysis to help a patient understand and address the underlying causes of their chronic depression.
5. A licensed psychologist conducting psychoanalysis sessions to help a patient overcome recurring nightmares and insomnia.
6. A psychiatrist using psychoanalysis techniques to help a patient gain insight into their addictive behaviors and develop healthier coping mechanisms.
7. A trained psychoanalyst working with a patient to explore the unconscious motivations behind their patterns of self-sabotage.
8. A licensed psychologist conducting psychoanalysis sessions to help a patient overcome deep-seated feelings of guilt and shame.
9. A psychiatrist using psychoanalysis techniques to help a patient understand and address the underlying causes of their social anxiety.
10. A trained psychoanalyst working with a patient to explore the unconscious motivations behind their patterns of self-sabotage.