Wiki Correct ICD-10 code for ADD (Attention Deficit Disorder)

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Hi everyone,
I code Behavioral Health and am trying to find out which ICD 10 dx code should be used for ADD--attention deficit disorder. My coding partner and I were both trained to use F90.0 Attention-deficit hyperactivity disorder, predominantly inattentive type. We are questioning whether or not F98.8 Other specified behavioral and emotional disorders with onset usually occurring in childhood and adolescence, would be more appropriate. I have found conflicting information in the DSM V, online, and in our ICD 10 2017 codebook. We are hoping someone out there can tell us which dx code they use for ADD. Thanks!
Kim Hess
Coding & Auditing Specialist
 
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Our office started using F98.8 but then received denials based on the patient's age. We only received reimbursement after submitting a corrected claim using F90.0 for our adult patients.
 
But youncannot use the F90.0 if documentation does not specify with hyperactivity. The F98.8 states onset occurring in childhood not thatbit cannot be used for an adult. You may need to appeal with documentation. But you cannot assign F90.0 without the documentation to support it.
 
well now I am confused. F98.8 has a P on it. In the guidelines you can only use those codes noted with a "P" for pediatrics 0-17 yrs of age. The index takes you to F98.8 without mention of Hyperactivity but I thought the "P" superseded it and have used F90.0, but the tabular guidelines says you may use F98 regardless of age so F98.8 would be the correct code? maybe payers are denying because of the "P". You may want to point out that guideline at the top of the F90 category. I may need to research this based upon payer. thanks for posting.
 
Interesting... my book does not have the p label. But the guidelines do say you may continue to use the code as long as the provider documents it.
It will not be a payer issue though, if the person does not have the hyperactivity documented then you have no other code to use.
 
Thank you everyone for the input...I do not see the P next to F98.8 in my book but I did find out the reason we started using F90.0 for ADD was because of payer denials due to patient's age. I agree that F98.8 is the appropriate code for ADD without mention of hyperactivity. Now I will have to wait and see what the payers do with it.
 
Changed in ICD-10 2017

If you look in the 2016 ICD-10 index, the look up path is Disorder, attention deficit w/o hyperactivity it directs you to code F90.0. In the 2017 ICD-10 index, the look up path disorder, attention deficit w/o hyperactivity directs you to code F98.8. My guess is they made a change in the code since category F90 includes the word "hyperactivity" in all the codes; however, I am still looking for official documentation to support my guess. In addition, the 2016 book does include the indicator that F98.8 is a pediatric only code; however this has been removed in 2017. Again, I'm guessing it is because the code descriptor for F98.8 states the condition "usually originates in childhood or adolescents," not that the patient is be a child/adolescent.
 
If you look in the 2016 ICD-10 index, the look up path is Disorder, attention deficit w/o hyperactivity it directs you to code F90.0. In the 2017 ICD-10 index, the look up path disorder, attention deficit w/o hyperactivity directs you to code F98.8. My guess is they made a change in the code since category F90 includes the word "hyperactivity" in all the codes; however, I am still looking for official documentation to support my guess. In addition, the 2016 book does include the indicator that F98.8 is a pediatric only code; however this has been removed in 2017. Again, I'm guessing it is because the code descriptor for F98.8 states the condition "usually originates in childhood or adolescents," not that the patient is be a child/adolescent.

Did you ever find the proper code to use for an adult with Attention Deficit Disorder? We are receiving denials for F98.8.
 
Did you ever find the proper code to use for an adult with Attention Deficit Disorder? We are receiving denials for F98.8.

If ADD is documented with mention of hyperactivity we have been using F90.0, Attention-deficit hyperactivity disorder, predominantly inattentive type. If ADD is documented without mention of hyperactivity we use F98.8. We have not had problems with denials.
 
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