ICD-10 Coding for Obsessive Compulsive Disorder(F42, F42.2, F42.3, F42.9)
Complete ICD-10-CM coding and documentation guide for Obsessive Compulsive Disorder. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Obsessive Compulsive Disorder
F42Primary Range
Obsessive-Compulsive Disorder
This range includes all primary codes for OCD, covering various subtypes and unspecified forms.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| F42 | Obsessive-Compulsive Disorder | Use when diagnosing general OCD without specifying a subtype. |
|
| F42.2 | Mixed Obsessional Thoughts and Acts | Use when both obsessions and compulsions are equally present. |
|
| F42.3 | Hoarding Disorder | Use when hoarding is the primary symptom. |
|
| F42.9 | Obsessive-Compulsive Disorder, Unspecified | Use when specific subtype cannot be determined. |
|
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 obsessive-compulsive disorder
Essential facts and insights about Obsessive Compulsive Disorder
Primary ICD-10-CM Codes for obsessive compulsive disorder
Decision Criteria
clinical Criteria
- Presence of time-consuming rituals and distressing thoughts
Applicable To
- Obsessions
- Compulsions
Excludes
- Obsessive-compulsive personality disorder (F60.5)
Clinical Validation Requirements
- Presence of obsessions and/or compulsions
- Symptoms cause significant distress or impairment
- Duration of symptoms is more than two weeks
Code-Specific Risks
- Confusion with OCPD (F60.5)
Coding Notes
- Ensure documentation specifies obsessions and compulsions clearly.
F42.2 - Mixed Obsessional Thoughts and Acts
Use when both obsessions and compulsions are equally present.
Applicable To
- Mixed obsessions and compulsions
Clinical Validation Requirements
- Equal focus on obsessions and compulsions
- Symptoms cause significant distress or impairment
Coding Notes
Document the balance between obsessions and compulsions.
F42.3 - Hoarding Disorder
Use when hoarding is the primary symptom.
Applicable To
- Hoarding behaviors
Clinical Validation Requirements
- Persistent difficulty discarding possessions
- Living spaces are cluttered
Coding Notes
Ensure documentation highlights hoarding as the primary issue.
F42.9 - Obsessive-Compulsive Disorder, Unspecified
Use when specific subtype cannot be determined.
Clinical Validation Requirements
- Symptoms meet OCD criteria but subtype is unclear
Coding Notes
Avoid use if more specific codes are applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Obsessive-Compulsive Personality Disorder
F60.5Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Obsessive Compulsive Disorder to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F42.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Increased risk of audit., Financial: Potential for denied claims.
Mitigation Strategy
Use specific language to describe symptoms, Include objective measures like Y-BOCS scores
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Ensure documentation specifies obsessions and compulsions for OCD.
Impact
Reimbursement: May result in lower reimbursement rates., Compliance: Increased audit risk., Data Quality: Reduces specificity in patient data.
Mitigation Strategy
Provide detailed documentation to support the use of unspecified codes.
Impact
High use of unspecified codes can trigger audits.
Mitigation Strategy
Provide detailed documentation to justify code use.
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 Obsessive Compulsive Disorder, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Obsessive Compulsive Disorder
Use these documentation templates to ensure complete and accurate documentation for Obsessive Compulsive Disorder. These templates include all required elements for proper coding and billing.
OCD with Mixed Symptoms
Specialty: PsychiatryRequired Elements
- Subjective report of obsessions and compulsions
- Objective findings such as Y-BOCS score
- Assessment linking symptoms to OCD criteria
- Plan including ERP or medication
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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