Communication is key in therapy. If you can’t understand or connect with a client, you typically can’t help them. Thankfully, there’s a billing code you can use in these situations, created by the American Medical Association (AMA) in 2013, called the interactive complexity code (90785).
The interactive complexity code is used when psychiatric services have been complicated by communication difficulties during the visit. This add-on code is meant to reflect increased intensity, not increased time, and must be used in conjunction with primary service codes.
Interactive complexity is often present with clients who:
Although interactive complexity is common during visits by children and adolescents, it may also apply to adults.
As stated in the CPT® manual, the 90785 code may be used when at least one of the following factors are present during the visit:
The 90785 code can’t be used in conjunction with:
You also generally shouldn't bill the 90785 code solely for the purpose of translation or interpretation services. That's because, according to the Centers for Medicare and Medicaid Services (CMS), federal laws prohibit discrimination, "which in this case would take the form of higher beneficiary payments and copayments for the same service, based on disability or ethnicity." So, use discernment when billing for translation or interpretation services.
When billing for interactive complexity, your billing form needs to include both the primary service code and the interactive complexity code, one after the other. You should use the same date for both codes and explain what the interactive complexity was exactly.
To learn how TherapyNotes™ can help you enter interactive complexity codes, visit our help center and read Add-On Codes.
* The content of this post is intended to serve as general advice and information. It is not to be taken as legal advice and may not account for all rules and regulations in every jurisdiction. For legal advice, please contact an attorney.