ICD-10 Coding for Behavioral Concerns(F91.1, F90.1)
Complete ICD-10-CM coding and documentation guide for Behavioral Concerns. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Behavioral Concerns
F01-F99Primary Range
Mental, Behavioral and Neurodevelopmental disorders
This range includes all mental and behavioral disorders, including those related to conduct and emotional regulation.
Persons with potential health hazards related to socioeconomic and psychosocial circumstances
These codes are used to capture social determinants that may impact behavioral health.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| F91.1 | Conduct disorder, childhood-onset type | Use when specific behaviors such as aggression, theft, and truancy are documented over a 6-month period. |
|
| F90.1 | Attention-deficit hyperactivity disorder, predominantly hyperactive type | Use when hyperactivity and impulsiveness are documented with evidence from assessments. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for conduct disorder
Essential facts and insights about Behavioral Concerns
Primary ICD-10-CM Codes for behavioral concern
Decision Criteria
clinical Criteria
- Presence of aggressive behavior, theft, or truancy for at least 6 months.
Applicable To
- Aggressive behavior
- Theft
- Truancy
Excludes
- Oppositional defiant disorder (F91.3)
Clinical Validation Requirements
- Documented aggressive behavior
- Recurrent theft
- Truancy for at least 6 months
Code-Specific Risks
- Misclassification if specific behaviors are not documented
Coding Notes
- Ensure documentation specifies the frequency and impact of behaviors.
F90.1 - Attention-deficit hyperactivity disorder, predominantly hyperactive type
Use when hyperactivity and impulsiveness are documented with evidence from assessments.
Applicable To
- Hyperactivity
- Impulsiveness
Excludes
- Anxiety disorders (F41.-)
Clinical Validation Requirements
- Vanderbilt or Conners assessment
- Symptoms present in multiple settings
Coding Notes
Document symptom frequency and impact on daily activities.
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 Behavioral Concerns to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F91.1.
Impact
Clinical: May lead to misdiagnosis., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Use specific behavioral descriptors., Include frequency and impact in notes.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Reduces specificity and accuracy of health records.
Mitigation Strategy
Use F03.91 when behavioral disturbances are documented.
Impact
Inadequate documentation of specific behaviors.
Mitigation Strategy
Use standardized templates and checklists.
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 Behavioral Concerns, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Behavioral Concerns
Use these documentation templates to ensure complete and accurate documentation for Behavioral Concerns. These templates include all required elements for proper coding and billing.
Conduct disorder in a school-aged child
Specialty: PediatricsRequired Elements
- Behavioral incidents
- Interventions
- Response to interventions
- Plan for ongoing management
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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