Interactive Complexity Coding

by Hawke Robinson — published Jun 20, 2015 05:05 PM, last modified Feb 05, 2023 12:22 PM

Where this will be accepted is still unclear, but it is something I came across during my time with Play Therapy, that seems very appropriate for Recreation Therapy / Therapeutic Recreation (RT / TR) and possibly some forms of RPG Therapy. It might only be applicable for mental health clients. I ran it by several professors, and facilities managers, and they were intrigued, but unable to provide further clarification. I welcome additional feedback from others.

It is technically listed for "psychotherapy" type services, so would only be applicable in mental health settings. I do not know if that automatically requires specific degree/occupation titles, I couldn't find any clarification about that. So I do not know what happens if a Therapeutic Recreation Specialist (TRS) applies for this, but
reading the details of the term, it seems eminently appropriate for TR for certain clients. Again, this is something I came across from the Play Therapy group, I do not know how applicable it can be for TR, but it seems it "should" be applicable, even if it isn't. :-)

This is regarding communication complexities to therapy that requires interactive activities for benefit, rather than usual speech methods. I suspect this is only technically applies for psychiatrists and psychologists, though the play therapists at the monthly meetings make it clear they can, and should, apply for a higher billable rate. Not all of the certified play therapists were either psychologists or psychiatrists (some were "just therapists" or "counselors"), so again, I don't know if it is possible to argue this for TR services targeting psychotherapy goals, but it seems an argument could be made if applied correctly to specific populations.

This PDF provides a lot more information,
https://www.dshs.wa.gov/sites/default/files/BHSIA/dbh/documents/2013_CPT_Module.pdf

Some key portions state:
"Interactive complexity may be reported with the above psychiatric procedures when at least one
of the following communication difficulties is present:
1. The need to manage maladaptive communication (related to, e.g., high anxiety, high reactivity, repeated questions, or disagreement) among participants that complicates delivery of care.
2. Caregiver emotions/behavior that interfere with implementation of the treatment plan.
3. Evidence/disclosure of a sentinel event and mandated report to a third party (e.g., abuse or neglect with report to state agency) with initiation of discussion of the sentinel event and/or report with patient and other visit participants.
4. Use of play equipment, physical devices, interpreter or translator to overcome significant language barriers.

When performed with psychotherapy, the interactive complexity component (+90785) relates only to the increased work intensity of the psychotherapy service, but does not change the time for the psychotherapy service."

I hope this helps others, and I would appreciate feedback if/when you find out applicability in for TR related psychotherapy program plans, or how it goes over for other disciplines and insurance companies.