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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:

OCD

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

CodeDescriptionWhen to UseKey Documentation
F42Obsessive-Compulsive DisorderUse when diagnosing general OCD without specifying a subtype.
  • Presence of obsessions and/or compulsions
  • Symptoms cause significant distress or impairment
  • Duration of symptoms is more than two weeks
F42.2Mixed Obsessional Thoughts and ActsUse when both obsessions and compulsions are equally present.
  • Equal focus on obsessions and compulsions
  • Symptoms cause significant distress or impairment
F42.3Hoarding DisorderUse when hoarding is the primary symptom.
  • Persistent difficulty discarding possessions
  • Living spaces are cluttered
F42.9Obsessive-Compulsive Disorder, UnspecifiedUse when specific subtype cannot be determined.
  • Symptoms meet OCD criteria but subtype is unclear

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

The ICD-10 code for obsessive-compulsive disorder is F42, with specific subcodes for different manifestations.

Primary ICD-10-CM Codes for obsessive compulsive disorder

Obsessive-Compulsive Disorder
Non-billable Code

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.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Obsessive-Compulsive Personality Disorder

F60.5
OCPD is characterized by pervasive perfectionism and control, whereas OCD involves intrusive thoughts and repetitive behaviors.

Documentation & 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: Psychiatry

Required 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

Patient reports intrusive thoughts about contamination and compulsive handwashing. Y-BOCS score: 26/40. Begin ERP therapy.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient has anxiety and repetitive behaviors.
Good Documentation Example
Patient reports intrusive thoughts about contamination (3–4 hours/day) with compulsive handwashing rituals causing cracked skin.
Explanation
The good example provides specific details about the obsessions and compulsions, meeting documentation requirements.

Need help with ICD-10 coding for Obsessive Compulsive Disorder? Ask your questions below.

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