Improve Your Insight on Eating Disorders
Question: Can you explain the difference between the three different codes related to binging and purging in the ICD-10-CM code book? Also, how do I know which code is appropriate and in which scenario? AAPC Forum Participant Answer: To answer this question, let’s first identify the three codes you’re referring to from the ICD-10-CM code book: When to use each of these codes will depend on certain circumstances, which can include the patient’s behaviors, mental outlook, and can sometimes depend on their weight as well. Bulimia describes someone who binges on food and then self-induces vomiting or misuses laxatives, diuretics, or enemas to quickly eliminate excess calories or food they have consumed. The patient record for someone suffering from bulimia nervosa will include notes on both compulsive binge eating and purging. For that, you’ll report F50.2. If the patient record describes binging and purging but also mentions excessive exercise, long stretches without eating, and extremely low weight, that is coded to F50.02. This is classified as a different condition because the patient is displaying a combination of behaviors wherein they cycle between anorexia (starving themselves, excessively exercising) and bulimia. Excludes1 instructions point to the difference, as they tell you not to report F50.2 with F50.02 and vice versa. On the other hand, when a patient binge eats but does not purge, you’ll turn to F50.81. Many of these patients will be overweight because they’re simply eating too much in one sitting too often. Take note: As with many mental health conditions, there may be complicated gray areas in which querying your provider may be necessary to code delicate situations more accurately. Lindsey Bush, BA, MA, CPC, Production Editor, AAPC
