How To Bill Electroconvulsive Therapy With CPT 90870

Electroconvulsive therapy can be reported with CPT 90870. Below the description and billing guidelines of this code.

1. CPT 90870

CPT code 90870 is described by the CPT manual as: “Electroconvulsive therapy (includes necessary monitoring).”

2. Procedure

The goal of the CPT 90870 procedure is to produce a seizure or series of seizures in order to to alleviate symptoms of mental disorders.

Electroconvulsive therapy, or ECT, is a psychiatric treatment a provider performs on a patient for whom conventional lines of treatment, such as prescribed medications and other psychotherapy, are not working.

ECT’s primary use is for the treatment of depression, but the provider may also consider ECT for other conditions, such as persistent life–threatening psychoses when the patient is suicidal or homicidal, and there is a need for a rapid alleviation of symptoms.

ECT causes changes in brain chemistry that quickly reverses some mental illness symptoms.

After the patient is appropriately prepped and anesthetized, the provider, usually a trained psychiatrist, applies an electric current to the brain for a fraction of a second through scalp electrodes to intentionally trigger a brief seizure that usually lasts less than 60 seconds.

ECT can be unilateral, in which electrical currents focus on one side of the brain, or bilateral, in which both sides of the brain receive the electrical currents.

CPT code 90870 includes the psychiatrist evaluation prior to performing an ECT procedure; time the physician takes to monitor the patient during the convulsive phase including the management of the seizure time by electroencephalographic tracing, and observation, and monitoring during the recovery phase.

Decision making regarding further treatment is part of the monitoring, as well.

3. Billing Guidelines

Report one unit of CPT 90870 only once per session.

If the provider evaluates the patient for a significant and separately identifiable evaluation and management service, you can report it with the appropriate established patient E/M code.

Append modifier 25 to the E/M code that you are reporting for the service to override the edit.

The exception is the psychodiagnostic evaluation code CPT 90792, which you bundle with CPT 90870. You cannot report these two codes together under any circumstances for physician services.

CPT 90870 is payable if you provide both services to the same patient on the same date.

4. ICD 10 Codes For CPT 90870