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The CPT® Code 90887 pertains to the interpretation or explanation of results from psychiatric evaluations, other medical examinations, and various procedures, as well as the discussion of accumulated data with family members or other responsible individuals involved in the care of a patient. This service is crucial in the context of mental and behavioral health, as it facilitates communication between healthcare providers and the patient's support system. During this process, the physician engages with family members or caregivers to clarify the patient's mental or behavioral condition, ensuring that they understand the implications of any diagnostic tests that have been conducted. The physician addresses any questions posed by the family or caregivers, providing them with a comprehensive understanding of the patient's situation. Furthermore, the discussion may encompass treatment alternatives, detailing the current treatment plan, which could involve various levels of care such as inpatient treatment, partial hospitalization, or outpatient services. The physician also reviews medications prescribed for the patient, including their dosages, intended therapeutic effects, and potential side effects. Additionally, any planned procedures aimed at treating the patient's condition are explained. Importantly, the physician may offer guidance on how family members and caregivers can assist the patient in managing their medical needs and performing activities of daily living, thereby enhancing the overall support system for the patient.
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The procedure associated with CPT® Code 90887 is indicated in various scenarios where family members or responsible individuals require clarification and understanding of a patient's mental or behavioral health condition. The following are specific indications for this service:
The procedure for CPT® Code 90887 involves several key steps that ensure effective communication between the physician and the patient's support system. The following outlines the procedural steps:
Post-procedure care following the interpretation or explanation of results under CPT® Code 90887 involves ensuring that family members or caregivers have a clear understanding of the information provided during the meeting. It is important for them to feel empowered to support the patient effectively. Follow-up may be necessary to address any further questions or concerns that arise after the initial discussion. Additionally, ongoing communication between the healthcare provider and the patient's support system is encouraged to adapt the treatment plan as needed and to ensure that the patient receives comprehensive care. Caregivers should be reminded to monitor the patient's progress and report any changes in behavior or health to the healthcare provider promptly.
| Short Descr | CONSULTATION WITH FAMILY | Medium Descr | INTERPJ/EXPLNAJ RESULTS PSYCHIATRIC EXAM FAMILY | Long Descr | Interpretation or explanation of results of psychiatric, other medical examinations and procedures, or other accumulated data to family or other responsible persons, or advising them how to assist patient | Status Code | Bundled Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | M5B - Specialist - psychiatry | MUE | 0 | CCS Clinical Classification | 218 - Psychological and psychiatric evaluation and therapy |
| 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | HO | Masters degree level | CG | Policy criteria applied | SA | Nurse practitioner rendering service in collaboration with a physician | 25 | Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 93 | Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system : synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located away at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that is sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. | AH | Clinical psychologist | AJ | Clinical social worker | AT | Acute treatment (this modifier should be used when reporting service 98940, 98941, 98942) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | ET | Emergency services | FQ | The service was furnished using audio-only communication technology | GC | This service has been performed in part by a resident under the direction of a teaching physician | GJ | "opt out" physician or practitioner emergency or urgent service | GT | Via interactive audio and video telecommunication systems | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GX | Notice of liability issued, voluntary under payer policy | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GZ | Item or service expected to be denied as not reasonable and necessary | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | SC | Medically necessary service or supply | U1 | Medicaid level of care 1, as defined by each state | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter |
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| Pre-1990 | Added | Code added. |
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