2025 CPT code 4320F
(Active) Effective Date: N/A Revision Date: N/A Performance Measurement - Therapeutic, Preventive or Other Interventions Category II Codes Feed
Patient counseled regarding psychosocial and pharmacologic treatment options for alcohol dependence (SUD).
Modifiers may be used to report additional information about the circumstances of the counseling session, but this requires detailed understanding of modifier guidelines and their application in this specific context. Refer to official CPT guidelines for detailed modifier application rules.
Medical necessity is established when a patient exhibits signs and symptoms consistent with alcohol dependence, indicating the need for counseling to discuss appropriate treatment options and guide the patient towards recovery.
The clinical responsibility lies with the healthcare professional (physician, therapist, or counselor) conducting the counseling session.They are responsible for providing accurate information on available treatment options, assessing the patient's needs, and developing an appropriate treatment plan.
In simple words: The doctor talked with the patient about different ways to deal with their alcohol problem, including therapy and medication.
This Category II CPT code represents the counseling provided to a patient regarding psychosocial and pharmacologic treatment options for alcohol dependence (Substance Use Disorder, SUD).The counseling session includes a discussion of various approaches to manage alcohol dependence, encompassing both behavioral therapies and medication options.
Example 1: A patient presents with symptoms of alcohol dependence and seeks help. The physician provides a counseling session detailing the various treatment options, including cognitive behavioral therapy (CBT), motivational interviewing, and medications such as naltrexone or acamprosate. This session is documented using code 4320F., A patient is referred to a substance abuse counselor for alcohol dependence.The counselor discusses the range of psychosocial interventions (e.g., support groups, individual therapy) and pharmacological options (e.g., disulfiram, acamprosate), tailoring the discussion to the patient's specific situation. This counseling session is documented with 4320F., During a routine checkup, a patient discloses concerns about their alcohol use. The primary care physician offers guidance on available resources, including brief interventions, self-help programs (e.g., Alcoholics Anonymous), and medication-assisted treatment. This counseling is coded as 4320F.
Documentation should include:Patient's history of alcohol use; assessment of the severity of alcohol dependence; detailed explanation of psychosocial and pharmacologic options discussed; patient's understanding and agreement on the chosen treatment path; referral information if applicable.
** This code is used to track the provision of counseling regarding treatment options for alcohol dependence. It is not a billable code in the traditional sense but serves as a performance measure.Always ensure compliance with payer-specific guidelines and local regulations.
- Payment Status: Active
- Modifier TC rule: Not applicable for this Category II code.
- Specialties:Addiction Medicine, Psychiatry, Primary Care, Family Medicine
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital,Telehealth Provided in Patient’s Home, Telehealth Provided Other than in Patient’s Home