CPT 90791 + ICD-10 F50.01: Anorexia nervosa, restricting type
Psychiatric diagnostic evaluation billed with Anorexia nervosa, restricting type — documentation requirements, denial reasons, modifiers, and reimbursement context.
CPT Code
90791
Psychiatric diagnostic evaluation
ICD-10 Code
F50.01
Anorexia nervosa, restricting type
Compatibility Notes
Used for the initial evaluation where AN restricting type is identified. The evaluation should document weight history, body image disturbance, and fear of weight gain. Medical monitoring coordination should be initiated at intake. Prior authorization may be required before ongoing treatment.
Documentation Required
- ✓Comprehensive evaluation with eating disorder history and current presentation
- ✓AN restricting type DSM-5 criteria documented
- ✓Weight history and current weight status (BMI)
- ✓Medical stability assessment and referral plan
- ✓Treatment team coordination initiated
Common Denial Reasons
- ✗90791 billed more than once per year by same provider
- ✗Medical monitoring referral not documented
- ✗Evaluation note reads like a therapy session rather than a diagnostic intake
Applicable Modifiers
Reimbursement Notes
OON UCR $175–$350. Eating disorder intake evaluations should always be billed as 90791. Prior authorization processes for ongoing treatment vary widely by plan.
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