Wiki Anxiety, Grief and depression diagnosis coding

Elizabethchris

Networker
Messages
37
Best answers
0
Hello,

An encounter was submitted with dx:

F33.42 Major depressive disorder, recurrent, in full remission
F43.20 Adjustment disorder, unspecified

But, if patient is noted to have anxiety, grief, and depression, should It have been reported as 3 separate codes:

F41.8-Mixed anxiety and depressive disorder
F43.23 Adjustment disorder with mixed anxiety and depressed mood or F43.21 Adjustment disorder with depressed mood
F33.42 Major depressive disorder, recurrent, in full remission (?)
 
Last edited by a moderator:
I would recommend only coding F43.23 for anxiety, grief and depression. See below. According to ICD-10 coding handbook:

"Coding of Infectious and Parasitic Diseases, Endocrine Diseases and Metabolic Disorders, and Mental Disorders
16 Mental Disorders
Reactions to Stress



ICD-10-CM provides category F43 for coding reaction to severe stress and adjustment disorders. Code F43.0, Acute stress reaction, classifies acute reaction to stress, including acute crisis reaction, combat fatigue, crisis state, and psychic shock. Acute stress reaction is the result of a person experiencing or witnessing a traumatic event that causes the individual to experience extreme, disturbing, or unexpected fear, stress, or pain and that involves or threatens serious injury, perceived serious injury, or death to self or someone else.

Posttraumatic stress disorder (PTSD) is classified in ICD-10-CM to subcategory F43.1, with fifth characters for unspecified, acute, or chronic. PTSD is a severe anxiety disorder that can develop after exposure to any event resulting in psychological trauma. As an effect of psychological trauma, PTSD is less frequent and more enduring than the more commonly seen acute stress response. Symptoms of PTSD include re-experiencing the original trauma(s) through flashbacks or nightmares; avoiding stimuli associated with the trauma; and experiencing increased arousal, such as difficulty falling or staying asleep, anger, and hypervigilance. These symptoms last more than one month and cause significant impairment in social, occupational, or other important areas of functioning. When PTSD occurs as a result of war, a code from category Y36, Operations of war, may be assigned to describe the external cause of the condition.

Adjustment disorders are a psychological response to an identifiable stressor or group of stressors that cause(s) significant emotional or behavioral symptoms. They differ from acute stress disorder and PTSD in that adjustment disorders are usually associated with a less-intense stressor. Adjustment disorders are classified to subcategory F43.2, with the fifth-character axis being the nature of the reaction--for example, anxiety, depression, disturbance of conduct, or other symptoms. The following situations fall into this category:


F43.21 Patient depressed over death of son
F43.24 Child adopted from a foreign country, suffering from culture shock with conduct disturbance
F43.21 Complicated bereavement (grief)"
 
Last edited by a moderator:
Top