ICD 10 Coding Alert

Question: How do you code a scenario where the patient has depression and anxiety? Do you code the two conditions separately or is there a combination code?

Illinois Subscriber

Answer: Depression and anxiety aren’t necessarily or automatically linked, according to the AHA ICD-10-CM Coding Clinic (2021, Volume 8, Number 1). Anxiety and depression being separate conditions means that you need to assign separate codes, unless your provider explicitly documents that the conditions are connected.

The Coding Clinic recommends you use codes such as F32.9 (Major depressive disorder, single episode, unspecified) and F41.9 (Anxiety disorder, unspecified) “when the documentation has not established a linkage between the depression and the anxiety.”

However, the article also says that it may be appropriate to use F41.8 (Other specified anxiety disorders) when “the provider does indicate a relationship between the two conditions.” The ICD-10-CM guidelines list anxiety depression (mild or not persistent) and mixed anxiety and depressive disorder as synonyms for the code.

The potential ambiguity of this situation is a good reason to query your provider about the specificity of the condition, and the type as well. If there is a note mentioning “a linkage in the documentation to indicate a single disorder” and that the linkage is “a distinct clinical diagnosis” such as mixed anxiety and depressive order, or MADD, it would be appropriate to use F41.8, per the Coding Clinic.

Rachel Dorrell, MA, MS, CPC-A, CPPM, Development Editor, AAPC