ICD Code F90.2

ICD code F90.2 is used to identify Attention-deficit hyperactivity disorder, combined type. This code is applied when a patient exhibits both inattentive and hyperactive-impulsive symptoms, which are characteristic of ADHD. It is a specific classification within the International Classification of Diseases (ICD) system, which helps healthcare providers document and manage patient diagnoses accurately for treatment and billing purposes.

1. Inattention Symptoms: The individual must exhibit at least six symptoms of inattention for children up to age 16, or five for adolescents 17 and older and adults. These symptoms should have persisted for at least six months to a degree that is inconsistent with developmental level and negatively impacts social and academic/occupational activities. Symptoms include:

- Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities.

- Often has difficulty sustaining attention in tasks or play activities.

- Often does not seem to listen when spoken to directly.

- Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace.

- Often has difficulty organizing tasks and activities.

- Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort.

- Often loses things necessary for tasks and activities.

- Is often easily distracted by extraneous stimuli.

- Is often forgetful in daily activities.

2. Hyperactivity and Impulsivity Symptoms: The individual must exhibit at least six symptoms of hyperactivity-impulsivity for children up to age 16, or five for adolescents 17 and older and adults. These symptoms should have persisted for at least six months to a degree that is disruptive and inappropriate for the person's developmental level. Symptoms include:

- Often fidgets with or taps hands or feet or squirms in seat.

- Often leaves seat in situations when remaining seated is expected.

- Often runs about or climbs in situations where it is inappropriate.

- Often unable to play or engage in leisure activities quietly.

- Is often "on the go," acting as if "driven by a motor."

- Often talks excessively.

- Often blurts out an answer before a question has been completed.

- Often has difficulty waiting their turn.

- Often interrupts or intrudes on others.

3. Combined Presentation: The symptoms of both inattention and hyperactivity-impulsivity must be present for the diagnosis of the combined type.

4. Age of Onset: Several inattentive or hyperactive-impulsive symptoms were present before age 12 years.

5. Setting: Several symptoms are present in two or more settings (e.g., at home, school, or work; with friends or relatives; in other activities).

6. Impact on Functioning: There must be clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning.

7. Exclusion of Other Disorders: The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, or a personality disorder).

For the ICD code F90.2, which pertains to Attention-deficit hyperactivity disorder, combined type, the relevant CPT codes that may be applicable for treatment and management include:

1. 99201-99215: Evaluation and Management (E/M) services for new or established patients, which may include office or other outpatient visits.

2. 96127: Brief emotional/behavioral assessment, with scoring and documentation, per standardized instrument.

3. 90832-90838: Psychotherapy services, which may be provided in 30, 45, or 60-minute sessions, depending on the specific needs of the patient.

4. 96130-96131: Psychological testing evaluation services, which may be necessary for a comprehensive assessment of ADHD symptoms.

5. 96136-96139: Psychological or neuropsychological test administration and scoring, which may be used to assess cognitive and behavioral functions.

6. 99241-99245: Consultation services provided by a specialist, which may be necessary for a more detailed evaluation or second opinion.

7. 90846-90847: Family psychotherapy services, which may be beneficial in managing ADHD symptoms within the family context.

These CPT codes are commonly used in the treatment and management of ADHD and can be billed accordingly based on the services provided to the patient. It is important for healthcare providers to ensure accurate coding to facilitate proper reimbursement and compliance with healthcare regulations.

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