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CPT 90791 + ICD-10 F50.02: Anorexia nervosa, binge-eating/purging type

Psychiatric diagnostic evaluation billed with Anorexia nervosa, binge-eating/purging type — documentation requirements, denial reasons, modifiers, and reimbursement context.

CPT Code
90791
Psychiatric diagnostic evaluation
ICD-10 Code
F50.02
Anorexia nervosa, binge-eating/purging type
Common Modifiers

Compatibility Notes

Used for the initial evaluation where AN binge-eating/purging type is identified. Medical stability is especially critical given purging-related cardiac and electrolyte risks. Immediate medical referral should be documented if not already engaged. Prior authorization processes begin post-intake.

Documentation Required

  • Comprehensive evaluation with eating disorder and purging behavior history
  • AN binge-eating/purging DSM-5 criteria documented
  • Medical safety assessment and urgent referral if indicated
  • Purging frequency and methods documented
  • Treatment team initiation plan

Common Denial Reasons

  • Medical referral not initiated at intake
  • 90791 billed more than once per year by same provider
  • Purging behaviors underreported in evaluation note

Applicable Modifiers

Reimbursement Notes

OON UCR $175–$350. Purging-type AN evaluations require urgent medical coordination documentation. Bill 90791 at intake and initiate prior authorization simultaneously.

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