ICD-10 Coding for ADD Evaluation(F90.0)
Complete ICD-10-CM coding and documentation guide for ADD Evaluation. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to ADD Evaluation
F90.0-F90.9Primary Range
Attention-deficit hyperactivity disorders
This range includes all types of ADHD, with F90.0 specifically for the inattentive type.
Key Information: ICD-10 code for ADD evaluation
Essential facts and insights about ADD Evaluation
Primary ICD-10-CM Code for add evaluation 10
Decision Criteria
clinical Criteria
- Presence of ≥6 inattentive symptoms from DSM-5
documentation Criteria
- Document symptoms across multiple settings
Applicable To
- ADD
- Predominantly inattentive presentation
Clinical Validation Requirements
- ≥6 DSM-5 inattentive symptoms
- Symptoms present for ≥6 months
- Onset before age 12
- Impairment in ≥2 settings
Code-Specific Risks
- Incorrectly using F90.9 when F90.0 criteria are met
- Not documenting specific DSM-5 symptoms
Coding Notes
- Ensure documentation supports the specific subtype of ADHD being coded.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting ADD Evaluation to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F90.0.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials or reduced reimbursement.
Mitigation Strategy
Use specific DSM-5 criteria, Include standardized assessment results
Impact
Reimbursement: May lead to reduced reimbursement due to unspecified coding., Compliance: Non-compliance with ICD-10 specificity requirements., Data Quality: Decreases accuracy of patient records.
Mitigation Strategy
Ensure documentation specifies inattentive symptoms to use F90.0.
Impact
Risk of audits due to unspecified ADHD coding.
Mitigation Strategy
Use specific codes and ensure documentation supports the subtype.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for ADD Evaluation, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for ADD Evaluation
Use these documentation templates to ensure complete and accurate documentation for ADD Evaluation. These templates include all required elements for proper coding and billing.
Pediatric ADD Evaluation
Specialty: PediatricsRequired Elements
- Symptom Inventory
- Impairment Evidence
- Rule-Out Documentation
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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