ICD 10 Coding Alert

Psychiatry:

Shift Focus to F48.2 For Reporting Pseudobulbar Affect in ICD-10

Published on Fri Oct 09, 2015

Hint: Don’t forget to report associated neurological or traumatic brain injury first.

If your clinician’s diagnosis is pseudobulbar affect (PBA), you have to just use a simple crossover code to report this diagnosis in ICD-10. In addition, the list of inclusions and exclusions are strikingly similar, so you will not have to alter your reporting much from the way you reported the condition using ICD-9.

ICD-9: In the past, when your psychiatrist arrives at a diagnosis of pseudobulbar affect, you reported the condition with the ICD-9 code, 310.81 (Pseudobulbar affect). You report the same diagnosis code if your clinician confirms a diagnosis of involuntary emotional expression disorder. Since this condition manifests with other neurological disorders or as a sequel to trauma to the brain, you will have to code these associated conditions first. Some of the conditions where you found pseudobulbar affect as an associated condition include:

Amyotrophic lateral sclerosis (335.20)
Multiple sclerosis (340)
Late effect of intracranial injury without mention of skull fracture (907.0)
Other late effects of cerebrovascular disease (438.89)

Caveat: You could not use 310.81 when reporting neuroses, personality disorders, or other nonpsychotic conditions occurring in a form similar to that seen with functional disorders but in association with a physical condition. You could use the code ranges, 300.0-300.9 and 301.0-301.9 to report this.

ICD-10: Now, you should be using F48.2 (Pseudobulbar affect) in lieu of 310.81. Just like ICD-9, you use the same diagnosis code if your psychiatrist arrives at a diagnosis of involuntary emotional expression disorder. Again, as in ICD-9, you have to report the associated neurological disorder or the traumatic disorder first when reporting a diagnosis of PBA. In ICD-10, the associated disorders are reported with the following codes: