CPT 90837 + ICD-10 F31.81: Bipolar II disorder
Psychotherapy, 60 minutes billed with Bipolar II disorder — documentation requirements, denial reasons, modifiers, and reimbursement context.
Compatibility Notes
A high-specificity code for Bipolar II disorder — characterized by hypomanic episodes and major depressive episodes without full manic episodes. This is the most commonly coded bipolar subtype in outpatient psychotherapy. Psychotherapy (particularly interpersonal and social rhythm therapy, CBT, or DBT) is evidence-based for Bipolar II alongside pharmacotherapy.
Documentation Required
- ✓Session start and stop times confirming 53+ minutes
- ✓Bipolar II diagnosis with documented history of hypomanic and depressive episodes
- ✓Current mood episode status documented
- ✓Coordination with prescribing provider noted (or documentation that patient is currently stable off medications)
- ✓Psychotherapy modality appropriate for bipolar disorder (IPSRT, CBT, DBT) specified in treatment plan
- ✓Safety screen for suicidal ideation (elevated in Bipolar II)
Common Denial Reasons
- ✗Notes do not document hypomania criteria met — using bipolar code without sufficient clinical basis
- ✗Payer may require psychiatrist or prescriber involvement for high-acuity bipolar presentations
- ✗Session time below 53 minutes without code correction to 90834
Applicable Modifiers
Reimbursement Notes
OON UCR $130–$210. Bipolar II psychotherapy is covered by all major commercial plans under mental health parity. Some plans require documentation of concurrent medication management for Bipolar II; ensure collaboration with prescriber is noted in the record.
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