ICD-10 Coding for Premenstrual Dysphoric Disorder(F32.81)
Complete ICD-10-CM coding and documentation guide for Premenstrual Dysphoric Disorder. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Premenstrual Dysphoric Disorder
F32-F39Primary Range
Mood [affective] disorders
PMDD is classified under mood disorders, specifically coded as F32.81.
Key Information: ICD-10 code for PMDD
Essential facts and insights about Premenstrual Dysphoric Disorder
Primary ICD-10-CM Code for pmdd
Decision Criteria
clinical Criteria
- Symptoms must meet DSM-5 criteria and be tracked over two cycles.
coding Criteria
- Use F32.81 for PMDD with documented DSM-5 criteria.
Applicable To
- PMDD
Excludes
- N94.3 (Premenstrual tension syndrome)
Clinical Validation Requirements
- Daily symptom tracking over at least two menstrual cycles
- Symptoms must occur during the luteal phase and resolve post-menses
- Documentation of DSM-5 criteria
Code-Specific Risks
- Incorrectly coding as N94.3, leading to reimbursement issues
- Lack of symptom tracking documentation
Coding Notes
- Ensure documentation explicitly links symptoms to the luteal phase.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Suicidal ideation
R45.851Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Premenstrual Dysphoric Disorder to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F32.81.
Impact
Clinical: Inaccurate diagnosis and treatment, Regulatory: Non-compliance with documentation standards, Financial: Potential claim denials
Mitigation Strategy
Use specific DSM-5 criteria in documentation, Link symptoms to menstrual cycle phases
Impact
Reimbursement: Denial of claims due to incorrect coding, Compliance: Non-compliance with ICD-10 coding standards, Data Quality: Inaccurate health records affecting patient care
Mitigation Strategy
Use F32.81 for PMDD as per current ICD-10 guidelines.
Impact
Using N94.3 instead of F32.81 for PMDD
Mitigation Strategy
Ensure documentation meets DSM-5 criteria and use F32.81.
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 Premenstrual Dysphoric Disorder, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Premenstrual Dysphoric Disorder
Use these documentation templates to ensure complete and accurate documentation for Premenstrual Dysphoric Disorder. These templates include all required elements for proper coding and billing.
Psychiatric evaluation for PMDD
Specialty: PsychiatryRequired Elements
- Symptom tracking over two cycles
- DSM-5 criteria documentation
- Functional impairment assessment
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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