How to use CPT code 90863 for psychiatric care
Learn how to properly use CPT code 90863 for pharmacologic management with psychotherapy.
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Billing and coding
ICD-10 codes for ADHD
A client presenting the symptoms of ADHD will most commonly be diagnosed with a specifier code that provides detail about how their symptoms present.
Diagnosis codes for attention-deficit hyperactivity disorder, or ADHD, are included in the ICD-10 under the section “Behavioral and emotional disorders with onset usually occurring in childhood and adolescence.”
Although it’s associated with adolescence taxonomically, many adults also experience symptoms of ADHD: It’s a disorder that begins in childhood but can be diagnosed at any age.
ADHD diagnosis requires formal testing from a licensed and trained professional.
It’s important that you make a clear, accurate and specific diagnosis that is appropriate to your individual patient clinical picture. These examples should be for reference and are not intended to guide a diagnosis. The client must meet diagnostic criteria for the F code they are assigned.
What are the most common ICD codes associated with ADHD?
A client presenting the symptoms of ADHD will most commonly be diagnosed with one of the following specifier codes, based on if their symptoms present as inattentive, hyperactive, both, or neither.
The most common diagnosis is combined type ADHD, where the client displays symptoms of both inattentive type and hyperactive type.
- F90.0 Attention-deficit hyperactivity disorder, predominantly inattentive type: Symptoms may include difficulty sustaining attention, forgetfulness.
- F90.1 Attention-deficit hyperactivity disorder, predominantly hyperactive type: Symptoms may include excessive fidgeting, or impulsive and impatient behavior.
- F90.2 Attention-deficit hyperactivity disorder, combined type: Displaying both inattentive and hyperactive-impulsive symptoms.
- F90.8 Attention-deficit hyperactivity disorder, other type: An atypical presentation not fitting the specified subtypes.
- F90.9 Attention-deficit hyperactivity disorder, unspecified type: A diagnosis without clear specification of predominant symptoms.
The diagnosis of symptoms for each subtype is based on the criteria description for F90: Hyperkinetic disorders:
A group of disorders characterized by an early onset (usually in the first five years of life), lack of persistence in activities that require cognitive involvement, and a tendency to move from one activity to another without completing any one, together with disorganized, ill-regulated, and excessive activity. Several other abnormalities may be associated. Hyperkinetic children are often reckless and impulsive, prone to accidents, and find themselves in disciplinary trouble because of unthinking breaches of rules rather than deliberate defiance. Their relationships with adults are often socially disinhibited, with a lack of normal caution and reserve. They are unpopular with other children and may become isolated. Impairment of cognitive functions is common, and specific delays in motor and language development are disproportionately frequent. Secondary complications include dissocial behavior and low self-esteem.
How to find other ADHD ICD codes
The World Health Organization’s official ICD-10 manual is available online, where you can find a list of diagnosis codes associated with ADHD symptoms, listed under F90–F98: “Behavioural and emotional disorders with onset usually occurring in childhood and adolescence."
The ICD-10 Database is another source for detailed clinical information about each ICD-10 code. This database is maintained by AAPC, the American Academy of Professional Coders.
Not all ICD-10 codes are accepted for insurance billing. Each insurance company typically has its own specific guidelines for claim submission, and have lists of covered and non-covered codes, so it’s important that you stay up to date with the billing requirements of the insurance plans you’re credentialed with to ensure the codes you’re using are supported for reimbursement.
What are exclusions for ADHD ICD-10 codes?
ICD-10 codes are often accompanied by exclusions. “Excludes notes” give providers information about how other ICD-10 codes can — or cannot — be used in relation to the one they’ve picked.
Type 1 excludes notes specify codes that cannot be used alongside codes for the condition in question. For example, bipolar disorder has a type 1 excludes note for major depressive disorder, because one person cannot have both. They are mutually exclusive diagnoses, and thus should never be coded together.
Type 2 excludes notes, meanwhile, specify codes that are not part of the condition in question, but may co-occur with it.
ICD-10 codes for ADHD do not have any type 1 exclusions. But they do have several type 2 exclusions:
- Anxiety disorders (F40.-, F41.-)
- Mood [affective] disorders (F30-F39)
- Schizophrenia (F20.-)
- Pervasive developmental disorders (F84.-)
How are ADHD ICD-10 specifiers different from DSM-5?
The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) and the ICD (International Classification of Diseases, Tenth Revision) are both classification systems used in the diagnosis of mental health disorders, but they have different origins, purposes, and scopes.
The DSM-5 is published by the American Psychiatric Association (APA), is used primarily in the United States, and focuses exclusively on mental disorders.
The ICD-10 is published by the World Health Organization (WHO), is used worldwide, and covers all health-related issues, not just mental disorders.
The DSM-5 is compatible with the ICD-10 coding system now in use by many insurance companies. Because it has a narrower scope, the DSM-5 includes more detail about the diagnostic criteria for mental disorders. The criteria included in the DSM-5 can be used to diagnose mental health disorders, and documentation should demonstrate the support of this diagnostic criteria.
This document is intended for educational purposes only. It is designed to facilitate compliance with payer requirements and applicable law, but please note that the applicable laws and requirements vary from payer to payer and state to state. Please check with your legal counsel or state licensing board for specific requirements.
Headway supports accurate billing to increase reimbursement success.
Using ICD-10 codes can feel complex at first; it’s almost like learning another language. No matter which condition you’re treating, coding, and billing for, Headway is there to help. The Headway platform includes integrated tools that support clinical assessment, diagnosis, claim submission, and billing — tasks that can otherwise become confusing and time-consuming for providers. Thanks to these resources and Headway’s guaranteed bi-weekly pay structure, providers can submit claims with confidence, knowing they’ll be fairly and quickly compensated for the great care they provide.
Billing and coding
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