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CPT 90791 + ICD-10 F32.9: Major depressive disorder, single episode, unspecified

Psychiatric diagnostic evaluation billed with Major depressive disorder, single episode, unspecified — documentation requirements, denial reasons, modifiers, and reimbursement context.

CPT Code
90791
Psychiatric diagnostic evaluation
ICD-10 Code
F32.9
Major depressive disorder, single episode, unspecified
Common Modifiers

Compatibility Notes

Used for initial evaluation of a patient presenting with a first depressive episode where severity has not yet been specified. F32.9 is appropriate as a placeholder diagnosis following the intake evaluation. Providers should update to a severity specifier in subsequent sessions.

Documentation Required

  • Comprehensive evaluation with mood episode history
  • PHQ-9 administered at intake
  • MDD criteria assessed and documented
  • Family history of mood disorders
  • Risk assessment including suicidal ideation
  • Treatment recommendations (therapy modality, medication referral if indicated)

Common Denial Reasons

  • 90791 billed more than once per benefit year by the same provider
  • Evaluation note lacks the scope expected for a diagnostic evaluation
  • Severity specifier should have been assigned — F32.9 may prompt specificity request

Applicable Modifiers

Reimbursement Notes

OON UCR $175–$350. Bill 90791 for every new patient intake; it is the highest-reimbursed session code available for outpatient therapists.

Related Billing Guides

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