ICD-10 Coding for Combative Behavior(R45.6, F03.A11)
Complete ICD-10-CM coding and documentation guide for Combative Behavior. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Combative Behavior
R45.6Primary Range
Physical and verbal aggressive behavior
Primary code for documenting general aggressive or combative behavior without specific psychiatric conditions.
Dementia with behavioral disturbance, agitation
Used when combative behavior is associated with dementia.
Conduct disorder, unspecified
Applicable for combative behavior in children with conduct disorders.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R45.6 | Physical and verbal aggressive behavior | Use when documenting general aggressive behavior not linked to a specific psychiatric condition. |
|
| F03.A11 | Dementia with behavioral disturbance, agitation | Use when combative behavior is associated with dementia. |
|
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 combative behavior
Essential facts and insights about Combative Behavior
Primary ICD-10-CM Codes for combative behavior
Decision Criteria
clinical Criteria
- Presence of aggressive acts without psychiatric diagnosis
documentation Criteria
- Detailed description of aggressive behavior
Applicable To
- Physical aggression
- Verbal aggression
Excludes
- Aggression due to psychiatric disorders
- Aggression due to substance use
Clinical Validation Requirements
- Documented physical acts such as hitting or kicking
- Verbal threats or aggressive language
Code-Specific Risks
- Misclassification if underlying psychiatric condition is present
Coding Notes
- Ensure documentation specifies the nature and context of aggressive acts.
F03.A11 - Dementia with behavioral disturbance, agitation
Use when combative behavior is associated with dementia.
Applicable To
- Agitation in dementia
Excludes
- Delirium
Clinical Validation Requirements
- Cognitive assessment indicating dementia
- Behavioral disturbances documented
Coding Notes
Ensure cognitive impairment is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Encounter for general psychiatric examination, requested by authority
Z04.6Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Borderline personality disorder
F60.3Alcohol withdrawal with perceptual disturbance
F10.121Delirium, not induced by alcohol and other psychoactive substances
F05Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Combative Behavior to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R45.6.
Impact
Clinical: Leads to misinterpretation of patient behavior., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials due to insufficient detail.
Mitigation Strategy
Use specific language to describe actions., Include context and any interventions.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Identify and code the underlying psychiatric condition first.
Impact
Risk of coding aggression without identifying underlying conditions.
Mitigation Strategy
Thoroughly assess and document any psychiatric or medical conditions.
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 Combative Behavior, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Combative Behavior
Use these documentation templates to ensure complete and accurate documentation for Combative Behavior. These templates include all required elements for proper coding and billing.
Emergency Department Aggression
Specialty: Emergency MedicineRequired Elements
- Specific aggressive acts
- Context and triggers
- Interventions attempted
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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