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Individual psychotherapy, as described by CPT® Code 90826, refers to a therapeutic intervention that is conducted in a structured environment, specifically within an inpatient hospital, partial hospital, or residential care setting. This type of psychotherapy is characterized by its interactive nature, utilizing various tools and methods such as play equipment, physical devices, and language interpreters to facilitate communication. The session typically lasts approximately 45 to 50 minutes and is conducted face-to-face with the patient. This approach is particularly beneficial for small children or individuals who may have difficulty with expressive verbal and written communication, allowing therapists to engage with them through non-verbal means. The use of toys and other physical aids helps to create a comfortable environment that encourages participation and expression, making it easier for the therapist to understand the patient's thoughts and feelings. It is important to note that if medical evaluation and management services are also provided during the session, CPT® Code 90827 should be used instead.
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The indications for utilizing CPT® Code 90826 include situations where individual psychotherapy is necessary for patients who may benefit from non-verbal communication methods. This is particularly relevant for:
The procedure for CPT® Code 90826 involves several key steps that ensure effective delivery of psychotherapy:
Post-procedure care following a session coded with CPT® Code 90826 typically involves monitoring the patient's emotional and psychological responses to the therapy. It is essential for the therapist to document the session's outcomes and any notable changes in the patient's behavior or emotional state. Follow-up sessions may be scheduled to continue the therapeutic process, and the therapist may also collaborate with other healthcare providers involved in the patient's care to ensure a comprehensive approach to treatment. Additionally, caregivers or family members may be involved in discussions to reinforce the therapeutic strategies used during the session.
| Short Descr | INTAC PSYTX HOSP 45-50 MIN | Medium Descr | INDIV PSYCTX IA INPT/PRTL HOSP/RESDNTL 45-50 MIN | Long Descr | Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an inpatient hospital, partial hospital or residential care setting, approximately 45 to 50 minutes face-to-face with the patient; | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Discontinued Code | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | M5B - Specialist - psychiatry | MUE | Not applicable/unspecified. | CCS Clinical Classification | 218 - Psychological and psychiatric evaluation and therapy |
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