CPT 90791 + ICD-10 F33.0: Major depressive disorder, recurrent, mild
Psychiatric diagnostic evaluation billed with Major depressive disorder, recurrent, mild — documentation requirements, denial reasons, modifiers, and reimbursement context.
CPT Code
90791
Psychiatric diagnostic evaluation
ICD-10 Code
F33.0
Major depressive disorder, recurrent, mild
Compatibility Notes
Initial evaluation for a patient with recurrent MDD currently in a mild episode. The prior episode history establishes the recurrent course at intake. PHQ-9 at intake should fall in the mild range (5-9). Most payers process this without additional scrutiny.
Documentation Required
- ✓Comprehensive evaluation with prior MDD episode history (confirming recurrent course)
- ✓PHQ-9 in mild range (5-9) at intake
- ✓Risk assessment
- ✓Treatment plan including relapse prevention component
Common Denial Reasons
- ✗90791 billed more than once per year by same provider
- ✗Prior episode not documented to justify recurrent specifier
- ✗PHQ-9 inconsistent with mild specifier
Applicable Modifiers
Reimbursement Notes
OON UCR $175-$350. Standard intake evaluation -- bill 90791 for all new patients.
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