ICD-10 Coding for Post-Traumatic Stress Disorder(F43.10, F43.11, F43.12)
Complete ICD-10-CM coding and documentation guide for Post-Traumatic Stress Disorder. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Post-Traumatic Stress Disorder
F43.1Primary Range
Post-Traumatic Stress Disorder
This range includes all codes related to PTSD, specifying different types and durations of the disorder.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| F43.10 | Post-traumatic stress disorder, unspecified | Use when the duration or severity of PTSD is not specified in the documentation. |
|
| F43.11 | Post-traumatic stress disorder, acute | Use for PTSD with symptoms lasting less than 3 months. |
|
| F43.12 | Post-traumatic stress disorder, chronic | Use for PTSD with symptoms persisting for more than 3 months. |
|
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 PTSD
Essential facts and insights about Post-Traumatic Stress Disorder
Primary ICD-10-CM Codes for ptsd
Decision Criteria
documentation Criteria
- Lack of specific duration in the patient's record.
Applicable To
- PTSD with unspecified duration
Excludes
- Acute stress reaction (F43.0)
Clinical Validation Requirements
- Documented trauma exposure
- Presence of PTSD symptoms without specified duration
Code-Specific Risks
- Risk of under-coding if duration is known but not documented.
Coding Notes
- Ensure trauma exposure is documented even if duration is unspecified.
F43.11 - Post-traumatic stress disorder, acute
Use for PTSD with symptoms lasting less than 3 months.
Applicable To
- PTSD with symptoms lasting less than 3 months
Excludes
- Chronic PTSD (F43.12)
Clinical Validation Requirements
- Documented trauma exposure
- Symptoms present for less than 3 months
Coding Notes
Ensure symptom duration is clearly documented.
F43.12 - Post-traumatic stress disorder, chronic
Use for PTSD with symptoms persisting for more than 3 months.
Applicable To
- PTSD with symptoms lasting more than 3 months
Excludes
- Acute PTSD (F43.11)
Clinical Validation Requirements
- Documented trauma exposure
- Symptoms persisting for more than 3 months
Coding Notes
Document the duration and persistence of symptoms clearly.
Differential 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 Post-Traumatic Stress Disorder to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F43.10.
Impact
Clinical: Inaccurate diagnosis and treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials or reduced reimbursement.
Mitigation Strategy
Ensure thorough documentation of symptom timeline., Regularly review patient records for completeness.
Impact
Reimbursement: Potential underpayment due to lack of specificity., Compliance: Non-compliance with coding guidelines requiring specificity., Data Quality: Decreased accuracy in health records.
Mitigation Strategy
Specify and document the duration to use F43.11 or F43.12 appropriately.
Impact
Lack of clear documentation on symptom duration can lead to audit issues.
Mitigation Strategy
Implement standardized templates for documenting PTSD symptoms and duration.
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 Post-Traumatic Stress Disorder, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Post-Traumatic Stress Disorder
Use these documentation templates to ensure complete and accurate documentation for Post-Traumatic Stress Disorder. These templates include all required elements for proper coding and billing.
PTSD following a car accident
Specialty: PsychiatryRequired Elements
- Trauma exposure details
- Symptom duration
- Functional impact
- Symptom frequency
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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