CPT 90837 + ICD-10 F50.01: Anorexia nervosa, restricting type
Psychotherapy, 60 minutes billed with Anorexia nervosa, restricting type — documentation requirements, denial reasons, modifiers, and reimbursement context.
Compatibility Notes
This combination is used by therapists providing psychotherapy as part of a multidisciplinary eating disorder treatment team. F50.01 signals restricting-type anorexia nervosa. Most insurers require coordination with a medical provider (physician or dietitian) for this diagnosis and may request evidence of a treatment team. Prior authorization is common and often required after session 10. CBT-E and FBT (Family-Based Treatment) are the evidence-based modalities expected by most payers.
Documentation Required
- ✓Session start and stop times confirming 53+ minutes
- ✓Documented eating disorder diagnosis with DSM-5 criteria (restriction, weight status, fear of weight gain, body image disturbance)
- ✓Weight and medical stability noted (or referral to medical provider documented)
- ✓Evidence-based modality in use (CBT-E, FBT, DBT for EDs)
- ✓Treatment team coordination documented if applicable
- ✓Prior authorization number on the superbill if required
Common Denial Reasons
- ✗Lack of documented medical monitoring — payers expect evidence that medical status is being tracked alongside psychotherapy
- ✗No prior authorization for eating disorder treatment beyond the initial evaluation
- ✗Diagnosis coded as F50.9 (eating disorder, unspecified) when F50.01 criteria are clearly met
- ✗Level of care mismatch — if patient's weight/labs suggest higher level of care (IOP, residential), OON outpatient claims may be denied
Applicable Modifiers
Reimbursement Notes
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