Psychiatry Coding & Reimbursement Alert

Question: Our psychiatrist recently saw a seven-year-old boy with autism, attention deficit hyperactivity disorder (ADHD) and significant cognitive delays. After evaluating the patient, our psychiatrist's report summary indicates autism with generalized developmental delays and ADHD. The summary also documented that his problems of short attention span and distractibility were related to the ADHD. Would it be appropriate to assign code 799.52, Attention or concentration deficit, as an additional diagnosis along with codes for the autism and ADHD?

New York Subscriber

Answer: When you are reporting the diagnosis, you will have to report autism as the first-listed diagnosis. You will have to report autism with the ICD-9 code 299.00 (Autistic disorder, current or active state). Next, report the attention deficit disorder with hyperactivity (ADHD) as the additional diagnosis. You can report it using the ICD-9 code 314.01 (Attention deficit disorder of childhood with hyperactivity).

Do not assign code 799.52 (Cognitive communication deficit), since it is a sign or symptom code for which you have a more definitive diagnosis of autism and ADHD. The "excludes note" at category 799.5 (Signs and symptoms involving cognition) indicates that signs and symptoms associated with a confirmed diagnosis of attention deficit disorder (314.00-314.01) would not be coded separately.