How To Use CPT Code 90899

CPT 90899 describes an unlisted psychiatric service or procedure that does not have a specific code. 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 90899?

CPT 90899 can be used to report psychiatric services or procedures that do not have a specific code. It is used when the provider performs a psychiatric service or procedure that is not represented by any of the standard and active CPT codes available.

2. Official Description

The official description of CPT code 90899 is an unlisted psychiatric service or procedure. There are no specific notes available for this code.

3. Procedure

1. When using CPT code 90899, the provider performs a psychiatric service or procedure that does not have a specific code available.
2. The procedure may involve various psychiatric services or procedures that are not covered by other CPT codes.
3. The provider should document the details of the service or procedure performed, including the specific nature of the service and any relevant clinical information.
4. It is important to provide a thorough description of the service or procedure to justify the use of the unlisted code.
5. Operative notes or other relevant documentation should be included to support the claim and avoid possible denial.

4. Qualifying circumstances

CPT 90899 can be used when the provider performs a psychiatric service or procedure that is not represented by any of the standard and active CPT codes available. This may occur when the specific service or procedure is not yet defined or when there is no appropriate code for the service or procedure performed.

5. When to use CPT code 90899

CPT code 90899 should be used when there is no specific code available to accurately represent the psychiatric service or procedure performed by the provider. It is important to note that this code should not be chosen if there is a code that closely approximates the service provided. Only use CPT 90899 when there is no specific procedure or service code that accurately describes the service or procedure performed.

6. Documentation requirements

To support a claim for CPT 90899, the provider should include the following documentation:

• A cover letter explaining the reason for choosing the unlisted code instead of a defined, active code
• Comparison to one or more similar codes to justify the claim amount
• Operative notes or other relevant documentation to strengthen the claim and avoid possible denial

7. Billing guidelines

When reporting CPT 90899, it is important to submit a cover letter explaining the reason for choosing the unlisted code instead of a defined, active code. Include one or more similar codes and compare the service or procedure to those codes to justify the claim amount. Additionally, include operative notes or other relevant documentation to strengthen the claim and avoid a possible denial. Payers will consider claims with unlisted procedure codes on a case-by-case basis and determine payment based on the documentation provided.

8. Historical information

CPT 90899 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A psychiatrist providing an innovative therapy session for a patient with treatment-resistant depression.
2. A psychologist conducting a comprehensive psychological evaluation for a child with behavioral issues.
3. A mental health counselor performing a specialized trauma-focused therapy session for a survivor of domestic violence.
4. A psychiatric nurse practitioner conducting a medication management session for a patient with bipolar disorder.
5. A social worker providing counseling services for a patient with substance use disorder.
6. A licensed professional counselor conducting a group therapy session for individuals with anxiety disorders.
7. A psychiatric technician assisting with a psychiatric emergency response team intervention.
8. A psychiatric nurse conducting a psychoeducation session for family members of patients with schizophrenia.
9. A behavioral analyst performing a functional behavior assessment for a child with autism spectrum disorder.
10. A psychiatric rehabilitation specialist providing vocational training for individuals with severe mental illness.