Interactive complexity 90785 for telehealth

Hi Kim,

We use it regularly with those we would do in a face to face visit.  No problem with insurance companies paying it.  Hope this helps!

Sheryl

Thanks Sheryl! 

When you say "with those we would do in a face to face visit" do you you mean in cases where the client would otherwise come into the office but does not bc of COVID risk concerns?

Thanks again.

K

Hi Kim,

I guess I mean if we would bill interactive complexity if they were in office, we bill it for telehealth.  

Sheryl

Hi Kim, I have used it with no issues when billed with individual therapy.  The reasons I use it include:  clients who are easily distracted and difficult if not impossible to redirect, clients who need significant de-escalation techniques during the session who may be yelling, swearing, communication issues if using an interpreter or writing things for hearing issues.  If doing teletherapy and the client has electronic problems such as video going on off/disconnect and re-connect.  I also may use it if a client brings a small child with as no daycare and the child is crying, disruptive, taking the focus off the session.  I just add a note about these issues in my progress note.

We also use this code regularly at our agency when appropriate as well and have not had any issues with insurance companies either.  

Amber

We have heard that agencies are using it for ALL telehealth simply bc it is telehealth.

Anyone on here doing that?  Using it for all telehealth?  Any problems with insurance companies?

Sheryl

We have received a few denials for the use of Interactive Complexity with telehealth sessions.  The denial indicated that "per DHS telehealth does not constitute interactive complexity".  One of the other criteria would also need to be met.  So, if using interactive tools via telehealth or client was extremely reactive, etc.... then Interactive Complexity could also be billed.  Your documentation needs to reflect the rationale for using this add on code. Hope that helps.