Pesky F Codes
This diagnosis should only be assigned when symptoms are directly linked to an identifiable life event such as divorce, job loss, or bereavement.
What is Adjustment Disorder?
This step must always be completed with both the client and the insurance company before billing for couples or family therapy.
What is verifying insurance coverage?
In Washington, this happens automatically for all clients when it comes to Greenspace assessments—no provider action required.
What is automatic enrollment of clients in Greenspace?
This CPT code is used only when a therapy session involves significant communication barriers beyond typical emotional distress.
What is interactive complexity (90785)?
Billing time begins at this moment for both in-person and telehealth therapy sessions.
What is when the therapist and client are together and actively engaged in the session?
This term describes how adjustment disorder is often used when the full clinical picture is not yet clear and symptoms may resolve as the stressor is addressed.
What is a provisional diagnosis?
These two CPT codes are used for billing couples or family therapy sessions, depending on who is present.
What are 90846 and 90847?
These four standardized measures are included in the default Greenspace assessment package.
What are PHQ-9, GAD-7, GAINS, and the Therapeutic Alliance?
The presence of this type of person may justify using 90785 when their involvement disrupts or significantly complicates communication in session.
Who is a disruptive third party, such as a parent or caregiver?
This common therapist activity must never be included in billed session time.
What is documentation or emails completed outside the session?
This is the recommended point at which clinicians should reevaluate an adjustment disorder diagnosis to determine whether a different diagnosis is more appropriate.
What is six months?
This is the individual who must receive the F code diagnosis when billing insurance for couples or family therapy.
Who is the insured individual whose coverage is being billed?
This is where completed Greenspace assessments appear for provider review, without logging into Greenspace.
What is the AMD document center?
This common clinical scenario does not qualify for interactive complexity coding on its own.
What is a client being emotionally upset or inconsolable?
When a telehealth session is disrupted by technical issues, therapists must bill only this portion and clearly document any gaps or transitions.
What is the actual face-to-face time spent with the client?
These two items must be clearly documented when using an adjustment disorder diagnosis.
What are the specific stressor and the rationale for the diagnosis?
When couples or family therapy extends beyond this timeframe, providers must reassess and update the diagnosis as needed.
What is six months?
Providers are expected to use Greenspace data in this way to support feedback-informed treatment and payer expectations.
What is informing treatment goals and documenting client progress?
This must be clearly documented to support use of 90785, especially given that insurance rarely reimburses for it.
What is the specific communication barrier and how it impacted the session?
These specific details must be recorded in the clinical note to support accurate billing and audit readiness.
What are the exact start and end times of the face-to-face session?
Using adjustment disorder for extended periods or across many clients may trigger this type of organizational review.
What is a clinical audit or leadership review?
If insurance coverage for couples/family therapy is not confirmed, this option should be considered.
What is private pay?
Research shows that using feedback informed treatment leads to this approximate increase in client engagement and this approximate decrease in no-shows and cancellations.
What is an 80% increase in client engagement and a 20% decrease in no-shows and cancellations?
Interactive complexity should be used sparingly because this is rarely provided by insurance and may require strong documentation.
What is reimbursement?
For telehealth sessions, this instruction applies to platform timers when calculating billable time.
What is to ignore the timer that starts when the client joins; billing time begins when the therapist joins and begins the session?