CPT 90791 + ICD-10 F43.21: Adjustment disorder with depressed mood
Psychiatric diagnostic evaluation billed with Adjustment disorder with depressed mood — documentation requirements, denial reasons, modifiers, and reimbursement context.
CPT Code
90791
Psychiatric diagnostic evaluation
ICD-10 Code
F43.21
Adjustment disorder with depressed mood
Common Modifiers
Compatibility Notes
Used for intake evaluation where the presenting problem is adjustment disorder with depressed mood. Appropriate when the evaluation confirms the stressor-linked depressive response without meeting full MDD criteria. 90791 should be billed for the intake regardless of diagnosis.
Documentation Required
- ✓Comprehensive evaluation with stressor history and onset
- ✓Adjustment disorder criteria assessed (disproportionate response, functional impairment)
- ✓MDD criteria exclusion documented
- ✓PHQ-9 at intake
- ✓Treatment recommendations
Common Denial Reasons
- ✗90791 billed more than once per year by same provider
- ✗Stressor not documented
- ✗Full MDD criteria met but adjustment disorder code used
Applicable Modifiers
Reimbursement Notes
OON UCR $175–$350. Bill 90791 for every intake regardless of the final diagnosis complexity.
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