ICD-10 Coding for Pervasive Developmental Disorder(F84.9, F84.0)
Complete ICD-10-CM coding and documentation guide for Pervasive Developmental Disorder. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pervasive Developmental Disorder
F80-F89Primary Range
Disorders of psychological development
This range includes pervasive developmental disorders, which encompass various developmental disorders including autism spectrum 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 |
|---|---|---|---|
| F84.9 | Pervasive developmental disorder, unspecified | Use when documentation specifies atypical autism or PDD-NOS without meeting criteria for other ASD subtypes. |
|
| F84.0 | Autistic disorder | Use when all three core domains of ASD are impaired. |
|
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 pervasive developmental disorder
Essential facts and insights about Pervasive Developmental Disorder
Primary ICD-10-CM Codes for pervasive developmental disorder
Decision Criteria
clinical Criteria
- Patient exhibits atypical autism symptoms without meeting full ASD criteria.
Clinical Validation Requirements
- Vineland Adaptive Behavior Scale ≤70
- Discrepancy ≥15 points between verbal/nonverbal IQ
Code-Specific Risks
- Using unspecified codes without documented rationale may lead to audits.
Coding Notes
- Ensure detailed documentation of developmental history and current impairments.
F84.0 - Autistic disorder
Use when all three core domains of ASD are impaired.
Applicable To
- Childhood autism
- Infantile autism
Excludes
- Asperger's syndrome (F84.5)
- PDD-NOS (F84.9)
Clinical Validation Requirements
- Childhood Autism Rating Scale (CARS) ≥30
- Documented symptom onset before age 3
Coding Notes
Ensure documentation includes all required domains of impairment.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other symbolic dysfunctions
R48.8Differential 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 Pervasive Developmental Disorder to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F84.9.
Impact
Clinical: May lead to misdiagnosis., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Use standardized assessment tools., Document specific symptoms.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: May trigger audits due to vague documentation., Data Quality: Inaccurate data collection for ASD prevalence.
Mitigation Strategy
Query for clarification if terms like 'high-functioning autism' are used.
Impact
Use of unspecified codes without justification.
Mitigation Strategy
Provide detailed documentation and rationale for code selection.
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 Pervasive Developmental Disorder, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pervasive Developmental Disorder
Use these documentation templates to ensure complete and accurate documentation for Pervasive Developmental Disorder. These templates include all required elements for proper coding and billing.
Developmental Pediatrics Consultation
Specialty: PediatricsRequired Elements
- Developmental history
- Behavioral observations
- Standardized measures
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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