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CPT 90791 + ICD-10 F43.23: Adjustment disorder with mixed anxiety and depressed mood

Psychiatric diagnostic evaluation billed with Adjustment disorder with mixed anxiety and depressed mood — documentation requirements, denial reasons, modifiers, and reimbursement context.

CPT Code
90791
Psychiatric diagnostic evaluation
ICD-10 Code
F43.23
Adjustment disorder with mixed anxiety and depressed mood
Common Modifiers

Compatibility Notes

Initial evaluation for a patient presenting with mixed anxious and depressive adjustment reaction. The evaluation should document the stressor, the onset timeline, and the absence of full primary mood or anxiety disorder criteria. A time-limited treatment plan should be initiated at intake.

Documentation Required

  • Comprehensive evaluation with stressor history
  • Mixed anxiety and depressed mood criteria documented
  • Primary mood and anxiety disorder differential addressed
  • Time-limited treatment plan at intake

Common Denial Reasons

  • 90791 billed more than once per year by same provider
  • Stressor not documented
  • Primary disorder criteria appear to be met without differential documentation

Applicable Modifiers

Reimbursement Notes

OON UCR $175–$350. 90791 should be used for all intake sessions regardless of diagnosis complexity.

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