CPT 90791 + ICD-10 F42.2: Mixed obsessional thoughts and acts (OCD)
Psychiatric diagnostic evaluation billed with Mixed obsessional thoughts and acts (OCD) — documentation requirements, denial reasons, modifiers, and reimbursement context.
CPT Code
90791
Psychiatric diagnostic evaluation
ICD-10 Code
F42.2
Mixed obsessional thoughts and acts (OCD)
Compatibility Notes
Initial evaluation for OCD. The evaluation should document obsession content and themes, compulsion types and time spent, functional impairment, and Y-BOCS or equivalent score. ERP should be identified as the evidence-based treatment at intake. Most payers cover 90791 for OCD evaluation without prior authorization.
Documentation Required
- ✓Comprehensive evaluation with OCD symptom history
- ✓Y-BOCS administered at intake
- ✓Obsession themes and compulsion types documented
- ✓Functional impairment across domains
- ✓ERP treatment plan initiated
Common Denial Reasons
- ✗90791 billed more than once per year by same provider
- ✗OCD criteria not documented specifically — notes describe anxiety without obsessions/compulsions
- ✗Evaluation note lacks the scope of a comprehensive diagnostic intake
Applicable Modifiers
Reimbursement Notes
OON UCR $175–$350. OCD evaluations are well-covered under mental health parity. Bill 90791 at intake for all OCD patients.
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