Pediatric Coding Alert

Question: I am confused by the F90.- codes, particularly which one to use when a patient is diagnosed with attention deficit disorder (ADD) rather than attention-deficit hyperactivity disorder (ADHD). How do I code it, and what do all the other codes describe?

Tennessee Subscriber

Answer: The F90.- codes are broken down in the following way:

• F90.0 (Attention-deficit hyperactivity disorder, predominantly inattentive type)
• F90.1 (Attention-deficit hyperactivity disorder, predominantly hyperactive type)
• F90.2 (Attention-deficit hyperactivity disorder, combined type)
• F90.8 (Attention-deficit hyperactivity disorder, other type)
• F90.9 (Attention-deficit hyperactivity disorder, unspecified type)

The key to using them is to know that they all describe various conditions related to attention-deficit hyperactivity disorder (ADHD). Typically, patients diagnosed with ADHD exhibit both inattention and hyperactivity, which means you would use F90.2 for ADHD unless your pediatrician offers a different ADHD diagnosis.

If the patient is diagnosed with ADD without hyperactivity, you should not use F90.8 (Attention-deficit hyperactivity disorder, other type) or F90.9 (Attention-deficit hyperactivity disorder, unspecified type), as both of these codes specifically mention hyperactivity in their descriptors. Instead, the ICD-10 index directs you to use F98.8 (Other specified behavioral and emotional disorders with onset usually occurring in childhood and adolescence).