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CPT 90847 + ICD-10 F43.22: Adjustment disorder with anxiety

Family psychotherapy with patient present billed with Adjustment disorder with anxiety — documentation requirements, denial reasons, modifiers, and reimbursement context.

CPT Code
90847
Family psychotherapy with patient present
ICD-10 Code
F43.22
Adjustment disorder with anxiety
Common Modifiers

Compatibility Notes

Common for family sessions addressing acute stress reactions — divorce proceedings, medical diagnoses, school transitions, or job loss — where anxiety is the predominant feature. This is a time-limited diagnosis (symptoms expected to resolve within 6 months of the stressor ending) and most insurers will expect the diagnosis to be updated or discontinued accordingly.

Documentation Required

  • Identified stressor(s) documented with onset date
  • Anxiety symptoms clearly disproportionate to the stressor's context (or causing significant impairment)
  • All session participants named with relationship to identified patient
  • Time-limited treatment plan with expected duration
  • Reassessment plan if symptoms persist beyond 6 months of stressor removal

Common Denial Reasons

  • Stressor not documented — payers may flag F43.xx codes without a documented precipitating event
  • Duration exceeds 6 months after stressor resolution without a diagnosis update
  • Patient not present in session — requires 90846 if patient is absent

Applicable Modifiers

Reimbursement Notes

Reimbursement for 90847/F43.22 is standard for the code: UCR $125–$200. Adjustment disorder diagnoses occasionally trigger shorter authorized session counts (e.g., 12 sessions instead of 30) from managed care plans, so verify authorization limits early.

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