Updated on: July 23, 2025
Introduction
In healthcare billing, ICD codes identify diagnoses, while CPT codes describe services. Understanding their interplay is essential for accurate reimbursement, compliance, and practice efficiency. This guide explores:
- The fundamentals of ICD vs. CPT
- Transitioning to ICD‑11 and ICD‑10‑CM updates
- Common mental health ICD codes
- Key CPT codes for evaluations, therapy, crisis & telehealth
- Modifier, place-of-service & billing documentation best practices
- Charts and workflow aids
- Real-world billing scenarios & audits
Let’s dive in to empower your practice.
What Are ICD Codes?
ICD (International Classification of Diseases) is a standardized diagnostic language. The current clinical version in the U.S. is ICD‑10‑CM, maintained by the WHO and required under HIPAA.
ICD Versions Overview
| Version | U.S. Adoption | Notes |
|---|---|---|
| ICD‑10 | Since 2015 | Used globally; basis for ICD-10-CM |
| ICD‑10‑CM | U.S. clinical variant | Annual updates required for compliance |
| ICD‑11 | Published 2018, endorsed 2019 | U.S. implementation ongoing |
Notable ICD‑10‑CM 2025 Updates
- F32.A: Major depressive disorder, single episode, mild with anxious distress
- F43.8A: Prolonged grief disorder
These reflect evolving diagnostic criteria—critical to update and integrate into clinical documentation.
ICD‑11: What Clinicians Should Know
ICD‑11 offers advanced specificity, dimensional models, and over 85,000 diagnostic entities. While its full U.S. use remains under discussion, psychiatrists should begin familiarizing themselves via WHO tools and clinical descriptions.
What Are CPT Codes?
CPT (Current Procedural Terminology) codes—five-digit numeric codes—are standardized by the AMA to report clinical services and procedures.
Categories of CPT Codes
- Category I: Core services (e.g. psychotherapy, evaluations)
- Category II & III: Performance measures, emerging services
- HCPCS Level II: Non-physician services and supplies (e.g., telehealth, durable medical equipment)
AMA Updates & Copyright
Annual updates include dozens of new or revised codes. The AMA holds copyright over CPT code content, and licensed access is required.
How ICD & CPT Work Together
ICD codes justify the medical necessity of CPT-coded services. For example:
- F32.A (MDD, mild with anxious distress) + 90834 (45‑min psychotherapy) supports mental health billing
- A mismatched pair (e.g., bronchitis + psychotherapy CPT) leads to insurance denials
Common Mental Health ICD‑10 Codes
Top 20 mental health diagnoses in U.S. outpatient practice:
| ICD Code | Diagnosis |
|---|---|
| F32.1 | Major depressive disorder, moderate |
| F41.1 | Generalized anxiety disorder |
| F33.1 | Major depressive disorder, recurrent |
| F43.10 | PTSD, unspecified |
| F90.0 | Attention-deficit hyperactivity disorder |
| F43.21 | Adjustment disorder with depressed mood |
| F84.0 | Autism spectrum disorder |
| F31.81 | Bipolar II disorder |
| F40.10 | Social anxiety disorder |
| F42.2 | Obsessive-compulsive disorder |
Key CPT Codes for Mental Health (2025)
Evaluation & Management (E&M)
Common outpatient E&M codes:
- 99202–99205: New patient office visits
- 99211–99215: Established patient visits
Psychiatric Evaluation
- 90791: Diagnostic evaluation, no medical services
- 90792: Diagnostic evaluation with medical services
Psychotherapy
| CPT Code | Description | Time (min) |
|---|---|---|
| 90832 | Individual psychotherapy | 16–37 |
| 90834 | Individual psychotherapy | 38–52 |
| 90837 | Individual psychotherapy | ≥53 |
| 90839 | Psychotherapy for crisis | 60 |
| +90840 | Add-on for additional crisis time (per 30 min) | — |
| 90846 | Family therapy without patient | ≥26 |
| 90847 | Family therapy with patient | ≥26 |
| 90853 | Group therapy | 46–60 |
| 90785 | Interactive complexity (used with therapy codes) | — |
Telebehavioral Health & HCPCS
- G0444: Annual depression screening
- G0396/G0397: Alcohol/substance abuse intervention
- 98966–98968: Telephone assessment
2025 CPT & ICD‑10 Updates
- Telehealth codes like 90834 and 90837 are now permanently reimbursable
- ICD‑10‑CM added new codes: F32.A, F43.8A
- Dozens of CPT revisions and HCPCS code expansions
Practical Billing Tables
ICD‑CPT Crosswalk
| ICD Code | Diagnosis | Common CPT Codes |
|---|---|---|
| F32.1 | Major depressive disorder, moderate | 90791, 90834, 99213 |
| F41.1 | Generalized anxiety disorder | 90834, 90837, 99214 |
| F90.0 | ADHD | 99204, 90837, 90785 |
| F43.10 | PTSD, unspecified | 90839, 90840, 90791 |
Telehealth Billing Snapshot
| CPT/HCPCS Code | Telehealth Eligible? | POS Code | Modifier |
|---|---|---|---|
| 90834 | Yes | 02 | -95 |
| 90791 | Yes | 02 | -95 |
| 90839/90840 | Yes | 02 | -95 |
| G0444 | Yes | 02 | None |
Documentation Essentials
To Avoid Claim Denials:
- Diagnosis must be supported by clinical documentation
- Service duration must match CPT time frame
- Use correct POS (Place of Service) and modifiers for telehealth
- Medical necessity must be established for every billed service
- Chart notes must match coding (especially time, symptoms, complexity)
Recommended Billing Workflow
- Start with diagnosis: Select appropriate ICD‑10 code
- Determine service type: Therapy, medication, evaluation
- Match duration to CPT: 90832 vs. 90834 vs. 90837
- Confirm modality: In-person or telehealth
- Apply correct POS & modifiers
- Review documentation before submission
Real-World Billing Scenarios
Scenario A: New Client with GAD
- ICD: F41.1
- CPT: 90791 (initial eval)
- Follow-up CPTs: 90834 for 45-minute therapy
- Telehealth: POS 02 + modifier -95
Scenario B: PTSD Crisis via Telehealth
- ICD: F43.10
- CPT: 90839 + 90840
- Notes must reflect at least 60 minutes of active crisis management
- Documentation must include interventions, risk assessment, and outcomes
Scenario C: Combined Therapy & Medication Visit
- ICD: F32.1
- CPT: 90836 (therapy + E&M)
- Requires documentation of both therapeutic and medical evaluation
Charts & Tools for Clinicians
Top 5 Most Used ICD Codes for Therapy Practices
| ICD Code | Diagnosis |
|---|---|
| F32.1 | Major depressive disorder, moderate |
| F41.1 | Generalized anxiety disorder |
| F90.0 | ADHD |
| F33.1 | MDD, recurrent |
| F43.10 | PTSD, unspecified |
Top 5 CPT Codes to Master
| CPT Code | Description | Time |
|---|---|---|
| 90791 | Initial psychiatric eval | Varies |
| 90834 | Individual therapy (45 min) | 38–52 min |
| 90837 | Individual therapy (60 min) | ≥53 min |
| 90839 | Crisis psychotherapy | 60 min |
| 90846 | Family therapy w/o patient | ≥26 min |
Audit & Compliance Tips
- Retain session notes that justify ICD selection
- Cross-check codes with EHR CPT suggestions
- Review insurer policies annually for coverage changes
- Use internal audits to verify CPT/ICD alignment
Conclusion
A solid grasp of ICD and CPT coding is non-negotiable for modern behavioral health practices. It ensures compliance, prevents claim denials, and sustains the financial health of your clinic. Stay updated, document with precision, and embrace digital workflows that automate the grunt work—so you can focus more on patient care.
Join DocScrib & Streamline Your Documentation
DocScrib makes medical documentation and billing effortless.
- ✅ Real-time ICD/CPT pairing suggestions
- ✅ AI-powered documentation that auto-generates compliant notes
- ✅ Templates for 90791, 90834, 99214, and more
- ✅ Telehealth-ready tools with modifier/POS pre-filled
Experience hassle-free documentation and billing—join DocScrib today and simplify your clinical workflow with one smart platform.