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Examining ICD-10-CM Codes for Mental, Behavioral and Neurodevelopmental Disorders – Part 4

There are certain disorders that arise in childhood and adolescence associated with problems related to conduct and dissocial behavior, attention deficit (hyperactivity) disorder, and tic disorders. The most common of these childhood disorders is Attention Deficit Disorder (ADD) which can continue into adulthood. It is thought to be a combination of several factors ranging from environmental factors, brain injury, nutritional deficiencies, and influences of the social environment. Researchers have done several studies that also suggest genes play a large role.

The symptoms that accompany ADD include difficulty staying focused and paying attention, impulsivity, and hyperactivity. It is necessary for the physician’s clinical documentation to differentiate ADD from hyperkinesia, hyperkinetic syndrome or conduct disorder, and just simple disturbances of activity and attention.

In ICD-10-CM there are different subtypes of ADD. A patient may display predominately hyperactivity-impulsivity symptoms and would be found in the hyperactivity-impulsivity categories. This patient may also exhibit some degree of inattention. Another type is the predominately inattentive subtype in which the majority of the patient’s symptoms involve inattention. These patients are therefore less likely to act out although they may still possess some symptoms of hyperactivity-impulsivity.

Finally, there is the combined-type of ADD that involves both the inattention and hyperactivity-impulsivity symptoms. According to statistics, most children have the combined type of ADD. For example, the table below illustrates this distinction in the different subtypes of ADD and what the ICD-10-CM codes look like compared to ICD-9-CM.

ICD-9-CM ICD-10-CM
DOCUMENTATION DOCUMENTATION
314.00 Attention deficit disorder without Mention of hyperactivity (inattentive type)

 

F90.0 Attention-deficit hyperactivity disorder, predominantly inattentive type
314.01 Attention deficit disorder with Hyperactivity (includes combined type) F90.1 Attention deficit hyperactivity disorder, predominately hyperactive type

F90.2 Attention-deficit hyperactivity disorder, combined type

314.1 Hyperkinesis with developmental delay

314.2 Hyperkinesis conduct disorder

314.8 Other specified manifestations of Hyperkinetic syndrome

F90.8 Attention-deficit hyperactivity disorder, Other type
314.9 Unspecified hyperkinetic syndrome

 

F90.9 Attention-deficit hyperactivity disorder Unspecified type

In ICD-10-CM, deficient attention disorders are indexed in multiple ways. In Category F90, attention-deficit syndrome with hyperactivity is included. Codes in categories F90-F98 may be applied regardless of the age of the patient. As mentioned earlier, these disorders can manifest in childhood and continue into adulthood or not be diagnosed until the patient has reached adulthood.

In ICD-10-CM, the codes for conduct disorders exclude any conduct problems in attention-deficit hyperactivity disorders. Attention deficit disorder will need to be clearly distinguished from signs and symptoms of attention and concentration deficits. Moving forward into ICD-10-CM, documentation of the etiology (cause) and any associated mental or organic illness is necessary.

NOTE: The table above is from the following source: Contexo Media. Best Practices for ICD-10-CM Documentation and Compliance 2012. Salt Lake City: Contexo Media, 2012. Print.

Continue to follow this series as we dig deep into the ICD-10-CM, Chapter 5 – Mental, Behavioral, and Neurodevelopmental Disorders.

For more ICD-10 articles, please visit our ICD-10 Updates page.

— Compiled by former CIPROMS ICD-10 Coordinator, Angela Hickman, CPC, CEDC, AHIMA-Approved ICD-10 CM/PCS Trainer, AHIMA Ambassador. All rights reserved. For use or reprint in your blog, website, or publication, please contact us at cipromsmarketing@ciproms.com.

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