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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ICD-10 codes for personality disorders
ICD-10 codes for impulse disorders
Billing and coding
ICD-10 codes for dissociative disorders
Navigate dissociative disorder ICD-10 codes with our guide. Learn about coding for diagnosis, billing, and insurance reimbursement for mental health providers.
Proper documentation is essential for accurate billing and timely payment. Along with identifying a billing code, you’ll need to find the right ICD-10 code for a diagnosis to include in your session notes and insurance claim.
Dissociative disorders are one diagnosis therapists frequently treat and bill. Below, learn more about ICD-10 codes for dissociative disorders to streamline your documentation and billing process as a therapist.
The ICD-10 classification system for dissociative disorders
Dissociative disorders fall under the ICD-10 F code F.44, or “Dissociative and conversion disorders.”
The disorders classified as F.44 involve disruptions or breakdowns in memory, identity, perception, or motor function, often triggered by psychological stress; in fact, a key characteristic of dissociative disorders is trauma history. Common examples include dissociative amnesia, dissociative identity disorder (previously known as multiple personality disorder), and conversion disorder, where psychological distress manifests as physical symptoms like paralysis or seizures.
F.44 diagnoses are complex and can be challenging to identify and document for insurance purposes. Accurate assessment and thorough documentation are essential for treatment planning and billing when working with clients experiencing dissociative symptoms.
F44 code breakdown and clinical applications
As with other F-codes, there are several subtypes of dissociative disorders, so it’s important to use the most accurate code possible when you’re diagnosing your client and filing insurance claims.
F44.0, Dissociative amnesia
F44.0, Dissociative amnesia is a disorder characterized by a retrospective gap in memory of important personal information, usually of a traumatic or stressful nature. The memory loss far exceeds ordinary forgetfulness and is not the result of substance use or the consequence of another mental disorder or medical condition.
F44.1, Dissociative fugue
F44.1, Dissociative fugue is a disorder characterized by sudden, unexpected travel away from one's home or place of work accompanied by an inability to recall one's past. With dissociative fugue, the individual is confused about his or her personal identity and may assume a new identity.
F44.2, Dissociative stupor
F44.2, Dissociative stupor is a disorder in which a person experiences a significant decrease or complete absence of voluntary movement and responsiveness to external stimuli, without a medical cause. The individual may appear motionless, mute, and unresponsive, yet maintains normal muscle tone and posture.
F44.4, Conversion disorder with motor symptom or deficit
F44.4, Conversion disorder with motor symptom or deficit is a condition where an individual experiences impaired motor function — such as paralysis, abnormal movements, tremors, or muscle weakness — that cannot be explained by a neurological or medical condition.
F44.5, Conversion disorder with seizures or convulsions
F44.5, Conversion disorder with seizures or convulsions is characterized by episodes that resemble epileptic seizures — such as shaking, loss of consciousness, or unresponsiveness — but are not caused by electrical disruptions in the brain.
F44.6, Conversion disorder with sensory symptom or deficit
F44.6, Conversion disorder with sensory symptom or deficit is marked by altered or absent sensory functions — such as numbness, loss of touch, vision, or hearing — that cannot be explained by a medical or neurological condition.
F44.7, Conversion disorder with mixed symptom presentation
F44.7, Conversion disorder with mixed symptom presentation is diagnosed when an individual experiences a combination of motor and sensory symptoms — such as weakness, tremors, numbness, or non-epileptic seizures — that cannot be explained by a medical or neurological condition.
F44.8, Other dissociative and conversion disorders
F44.81 Dissociative identity disorder
F44.81, Dissociative identity disorder is characterized by the presence of two or more identities with distinct patterns of perception and personality which recurrently take control of the person's behavior. This is accompanied by a retrospective gap in memory of important personal information that far exceeds ordinary forgetfulness. With DID, the changes in identity are not due to substance use or to a general medical condition.
F44.89, Other dissociative and conversion disorders
F44.89, Other dissociative and conversion disorders is a category used for dissociative or conversion symptoms that do not fully meet the criteria for more specific F44 diagnoses. Individuals may experience a range of psychological or physical symptoms — such as identity disturbances, altered perception, or motor and sensory issues — that stem from emotional distress without a clear neurological or medical cause. This diagnosis allows for clinical flexibility when symptoms are significant and impairing but don't neatly fit into another dissociative or conversion disorder category.
F44.9, Dissociative and conversion disorder, unspecified
F44.9, Dissociative and conversion disorder, unspecified is used when a person exhibits symptoms of a dissociative or conversion disorder, but the presentation does not clearly align with any specific diagnosis within the F44 category. These symptoms may include disruptions in consciousness, identity, memory, perception, motor function, or sensation that cannot be explained by a medical condition. The unspecified code is typically used when there is insufficient information to make a more precise diagnosis or when the clinician chooses not to specify the exact nature of the disorder.
Comparing ICD-10 and DSM-V-TR classifications
Dissociative disorders are recognized in both the ICD-10 and the DSM-V-TR, but there are some key differences in how they’re classified and coded.
In the ICD-10, dissociative disorders fall under the F40 category, or “Dissociative and conversion disorders.” The ICD-10 provides several more specific codes to accurately reflect presenting symptoms. This system allows for more detailed coding and is used for insurance and billing purposes.
The DSM-V-TR, meanwhile, groups dissociative disorders in a dedicated section called “Dissociative Disorders.” It describes specific diagnoses like dissociative identity disorder, dissociative amnesia, and depersonalization/derealization disorder, focusing on diagnostic criteria such as disruptions in consciousness, memory, identity, or perception.
Documentation best practices for dissociative disorders
Proper documentation is essential for diagnosing and billing for dissociative disorders. To be diagnosed with F44.0 dissociative amnesia, someone usually experiences:
- Inability to recall important personal information (usually trauma- or stress-related) that would not typically be lost with ordinary forgetting.
- Symptoms that cause significant distress or significantly impair social or occupational functioning.
- Symptoms that cannot be better accounted for by the effects of a medication or another disorder such as dementia, substance use disorder, traumatic brain injury, post-traumatic stress disorder, partial complex seizures, or another dissociative disorder.
Following a documentation checklist can help make sure you include everything needed for compliance and prompt payment. If you diagnose a client with a dissociative disorder, you can create your treatment plan accordingly and use the correct CPT codes when you file insurance claims.
It’s important 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.
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Billing and coding
How to use CPT code 90863 for psychiatric care
ICD-10 codes for personality disorders
Personality disorders fall under ICD-10 F60, or “specific personality disorders.”
ICD-10 codes for impulse disorders
Learn about impulse disorder ICD-10 coding with our guide, including overviews of classification for proper documentation, treatment planning, and insurance claims.