ICD-10 Coding for Trauma and Stressor-Related Disorders(F43.10, F43.11, F43.12, F43.0, F43.2)
Complete ICD-10-CM coding and documentation guide for Trauma and Stressor-Related Disorders. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Trauma and Stressor-Related Disorders
F43.0-F43.9Primary Range
Reaction to severe stress, and adjustment disorders
This range includes all codes related to trauma and stressor-related disorders, including PTSD, acute stress reaction, and adjustment 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 |
|---|---|---|---|
| F43.10 | Post-traumatic stress disorder, unspecified | Use when PTSD symptoms are present but duration or specific criteria are not documented. |
|
| F43.11 | Post-traumatic stress disorder, acute | Use when PTSD symptoms are present for less than 3 months. |
|
| F43.12 | Post-traumatic stress disorder, chronic | Use when PTSD symptoms persist for 3 months or more. |
|
| F43.0 | Acute stress reaction | Use when symptoms resolve within 1 month of trauma. |
|
| F43.2 | Adjustment disorders | Use when symptoms do not meet PTSD criteria and resolve within 6 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 chronic PTSD
Essential facts and insights about Trauma and Stressor-Related Disorders
Primary ICD-10-CM Codes for trauma and stressor related disorder
Decision Criteria
documentation Criteria
- Lack of specific symptom duration or criteria
Applicable To
- PTSD symptoms without specific duration
Clinical Validation Requirements
- Symptoms of PTSD present but duration or specific criteria not fully documented
Code-Specific Risks
- Overuse due to lack of specific documentation
Coding Notes
- Ensure documentation specifies symptom duration and criteria met.
F43.11 - Post-traumatic stress disorder, acute
Use when PTSD symptoms are present for less than 3 months.
Applicable To
- PTSD symptoms lasting less than 3 months
Excludes
- Chronic PTSD (F43.12)
Clinical Validation Requirements
- Symptoms present for less than 3 months following trauma
Coding Notes
Document specific onset and duration of symptoms.
F43.12 - Post-traumatic stress disorder, chronic
Use when PTSD symptoms persist for 3 months or more.
Applicable To
- PTSD symptoms persisting for 3 months or more
Excludes
- Acute PTSD (F43.11)
Clinical Validation Requirements
- Symptoms persist for 3 months or more following trauma
Coding Notes
Ensure documentation specifies symptoms have persisted for 3 months or more.
F43.0 - Acute stress reaction
Use when symptoms resolve within 1 month of trauma.
Applicable To
- Symptoms resolving within 1 month of trauma
Excludes
- PTSD (F43.1x)
Clinical Validation Requirements
- Symptoms resolve within 1 month following trauma
Coding Notes
Document resolution of symptoms within 1 month.
F43.2 - Adjustment disorders
Use when symptoms do not meet PTSD criteria and resolve within 6 months.
Applicable To
- Emotional or behavioral symptoms in response to stressor
Excludes
- PTSD (F43.1x)
Clinical Validation Requirements
- Symptoms do not meet criteria for PTSD and resolve within 6 months of stressor
Coding Notes
Ensure symptoms do not meet PTSD criteria and resolve within 6 months.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
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 Trauma and Stressor-Related Disorders to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F43.10.
Impact
Clinical: Leads to inaccurate diagnosis coding., Regulatory: Increases risk of audit and non-compliance., Financial: May result in lower reimbursement.
Mitigation Strategy
Train staff on documentation requirements., Use templates to ensure complete documentation.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Increases risk of audit and non-compliance., Data Quality: Reduces accuracy of clinical data.
Mitigation Strategy
Ensure documentation supports specific code selection based on symptom duration and criteria.
Impact
Reimbursement: Incorrect sequencing can affect DRG assignment., Compliance: Violates coding guidelines., Data Quality: Compromises data integrity.
Mitigation Strategy
Sequence trauma codes before PTSD codes when applicable.
Impact
Frequent use of unspecified codes without justification can trigger audits.
Mitigation Strategy
Ensure documentation supports specific 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 Trauma and Stressor-Related Disorders, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Trauma and Stressor-Related Disorders
Use these documentation templates to ensure complete and accurate documentation for Trauma and Stressor-Related Disorders. These templates include all required elements for proper coding and billing.
Chronic PTSD in a Veteran
Specialty: PsychiatryRequired Elements
- Detailed symptom description
- Duration of symptoms
- Functional impact
- Trauma history
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Trauma and Stressor-Related Disorders? Ask your questions below.