CPT 90791 + ICD-10 F34.1: Dysthymic disorder (persistent depressive disorder)
Psychiatric diagnostic evaluation billed with Dysthymic disorder (persistent depressive disorder) — documentation requirements, denial reasons, modifiers, and reimbursement context.
CPT Code
90791
Psychiatric diagnostic evaluation
ICD-10 Code
F34.1
Dysthymic disorder (persistent depressive disorder)
Compatibility Notes
Initial evaluation for PDD. The evaluation must document the 2-year minimum duration of chronic low-grade depression. Distinguishing PDD from episodic MDD is important and should be addressed in the diagnostic impression. Most payers process this combination without additional scrutiny.
Documentation Required
- ✓Comprehensive evaluation with depressive symptom history (documenting 2-year duration)
- ✓PHQ-9 at intake
- ✓MDD vs PDD differential documented
- ✓Functional impairment in occupational and social domains
- ✓Treatment plan (CBASP, behavioral activation, CBT)
Common Denial Reasons
- ✗Two-year duration not documented in the evaluation
- ✗90791 billed more than once per year by same provider
- ✗Evaluation reads like a therapy note
Applicable Modifiers
Reimbursement Notes
OON UCR $175–$350. PDD intake evaluations are covered under mental health parity. Document the chronic course clearly to establish medical necessity for long-term therapy.
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