ICD-10 Coding for Autism Spectrum Disorder(F84.0)
Complete ICD-10-CM coding and documentation guide for Autism Spectrum Disorder. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Autism Spectrum Disorder
F84.0-F84.9Primary Range
Pervasive developmental disorders
This range includes all pervasive developmental disorders, with F84.0 specifically for Autistic Disorder.
Specific developmental disorders of speech and language
This range is relevant for documenting speech and language disorders often associated with ASD.
Key Information: ICD-10 code for autism spectrum disorder
Essential facts and insights about Autism Spectrum Disorder
Primary ICD-10-CM Code for autism spectrum disorder
Decision Criteria
clinical Criteria
- Presence of social communication deficits and repetitive behaviors
documentation Criteria
- Detailed documentation of DSM-5 criteria
Clinical Validation Requirements
- Deficits in social-emotional reciprocity
- Restricted, repetitive patterns of behavior
Code-Specific Risks
- Incorrect sequencing with comorbid conditions
- Missing severity level
Coding Notes
- Ensure documentation includes DSM-5 criteria and severity levels.
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 Autism Spectrum Disorder to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F84.0.
Impact
Clinical: Inadequate treatment planning, Regulatory: Non-compliance with coding guidelines, Financial: Potential claim denials
Mitigation Strategy
Always document severity level, Review DSM-5 criteria
Impact
Reimbursement: Claims may be denied due to conflicting codes., Compliance: Non-compliance with ICD-10 coding rules., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure F84.0 and F84.5 are not used together; choose based on clinical presentation.
Impact
Incorrect sequencing of primary and secondary codes.
Mitigation Strategy
Review payer-specific guidelines and ensure proper documentation.
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 Autism Spectrum Disorder, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Autism Spectrum Disorder
Use these documentation templates to ensure complete and accurate documentation for Autism Spectrum Disorder. These templates include all required elements for proper coding and billing.
Child with ASD and language delay
Specialty: PediatricsRequired Elements
- Diagnosis
- Severity level
- DSM-5 criteria
- Comorbid conditions
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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