How To Use CPT Code 90885

CPT 90885 describes the process of psychiatric evaluation of hospital records, other psychiatric reports, psychometric and/or projective tests, and other accumulated data for medical diagnostic purposes. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 90885?

CPT 90885 can be used to describe the psychiatric evaluation of a patient’s medical records, psychiatric reports, and various tests to assist in establishing a diagnosis and treatment plan. This code is used when a provider reviews and analyzes the accumulated data to gain insights into the patient’s hidden behavior, emotions, and responses to stimuli. The evaluation may involve psychometric and projective tests to assess the patient’s mental status and reveal their personality traits.

2. Official Description

The official description of CPT code 90885 is: ‘Psychiatric evaluation of hospital records, other psychiatric reports, psychometric and/or projective tests, and other accumulated data for medical diagnostic purposes.’

3. Procedure

1. The provider carefully reviews the patient’s medical records, including hospital records and other psychiatric reports.
2. Psychometric and projective tests may be administered to gather additional information about the patient’s mental status and personality traits.
3. The provider analyzes the accumulated data, including the test results, to gain insights into the patient’s hidden behavior, emotions, and responses to stimuli.
4. Based on the evaluation, the provider uses the data to assist in making a medical diagnosis and determining an appropriate treatment plan for the patient.

4. Qualifying circumstances

CPT 90885 is typically used for patients who require a comprehensive psychiatric evaluation based on their medical records, psychiatric reports, and the need for psychometric and/or projective tests. This code is applicable when the provider needs to assess the patient’s hidden behavior, emotions, and responses to stimuli to establish a diagnosis and develop a treatment plan. The evaluation may be necessary for patients with complex psychiatric conditions or those who have not responded well to previous treatments.

5. When to use CPT code 90885

CPT code 90885 should be used when a provider performs a comprehensive psychiatric evaluation using the patient’s medical records, psychiatric reports, and psychometric and/or projective tests. This code is appropriate when the evaluation is conducted for medical diagnostic purposes and helps in establishing a diagnosis and treatment plan. It is important to note that CPT code 90885 should not be used for routine follow-up visits or brief assessments that do not involve a comprehensive evaluation of accumulated data.

6. Documentation requirements

To support a claim for CPT code 90885, the provider must document the following information:

• Patient’s medical records and psychiatric reports reviewed
• Details of any psychometric and/or projective tests administered
• Analysis of the accumulated data, including test results
• Medical diagnosis and treatment plan based on the evaluation
• Signature of the provider performing the evaluation

7. Billing guidelines

When billing for CPT code 90885, ensure that the evaluation meets the criteria outlined in the official description. It is important to document the necessary information and provide a thorough analysis of the accumulated data. CPT code 90885 should not be reported with other codes unless additional services, such as psychotherapy, are provided separately. It is crucial to follow the specific guidelines provided by the payer and accurately report the services rendered.

8. Historical information

CPT code 90885 was added to the Current Procedural Terminology system on January 1, 1998. There have been no updates or changes to the code since its addition.

9. Examples

1. A psychiatrist reviewing a patient’s medical records, conducting psychometric tests, and analyzing the data to diagnose and develop a treatment plan for a patient with schizophrenia.
2. A psychologist evaluating a patient’s psychiatric reports, administering projective tests, and using the accumulated data to assess the patient’s personality traits and provide recommendations for therapy.
3. A psychiatric nurse practitioner reviewing a patient’s hospital records, conducting psychometric tests, and analyzing the data to assist in diagnosing and managing a patient with bipolar disorder.
4. A licensed clinical social worker analyzing a patient’s medical records, administering projective tests, and using the accumulated data to assess the patient’s emotional responses and develop a treatment plan for anxiety disorder.
5. A neuropsychologist reviewing a patient’s psychiatric reports, conducting psychometric tests, and analyzing the data to assess the patient’s cognitive functioning and provide recommendations for rehabilitation after a traumatic brain injury.