ICD Code F43.10

ICD code F43.10 is used to identify a diagnosis of post-traumatic stress disorder (PTSD) without specifying any particular details about the condition's characteristics or severity. This code is applied when a patient exhibits symptoms of PTSD, such as re-experiencing traumatic events, avoidance of reminders, negative changes in thoughts and mood, and heightened arousal, but the healthcare provider does not specify additional details like the duration or specific triggers of the disorder. It serves as a general classification for PTSD in medical records and billing.

1. Exposure to Traumatic Event: The individual must have been exposed to a traumatic event, which could include experiencing, witnessing, or being confronted with an event that involved actual or threatened death, serious injury, or a threat to the physical integrity of oneself or others.

2. Intrusive Symptoms: The presence of one or more intrusive symptoms associated with the traumatic event, such as distressing memories, dreams, or flashbacks, where the individual feels or acts as if the traumatic event is recurring.

3. Avoidance: Persistent avoidance of stimuli associated with the trauma, which may include avoiding thoughts, feelings, or conversations about the traumatic event, as well as avoiding people, places, or activities that trigger memories of the trauma.

4. Negative Alterations in Cognitions and Mood: Marked negative changes in thoughts and mood related to the traumatic event, which may include an inability to remember important aspects of the trauma, persistent negative beliefs about oneself or the world, distorted blame of self or others, persistent negative emotional state, diminished interest in activities, feelings of detachment, or inability to experience positive emotions.

5. Alterations in Arousal and Reactivity: Symptoms of increased arousal and reactivity that began or worsened after the traumatic event, such as irritability, angry outbursts, reckless or self-destructive behavior, hypervigilance, exaggerated startle response, problems with concentration, or sleep disturbances.

6. Duration: The symptoms must persist for more than one month following the traumatic event.

7. Functional Impairment: The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

8. Exclusion of Other Causes: The symptoms are not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition.

For the ICD code F43.10, which pertains to post-traumatic stress disorder, unspecified, the relevant CPT codes that may be applicable for treatment include:

1. 90832 - Psychotherapy, 30 minutes with patient

2. 90834 - Psychotherapy, 45 minutes with patient

3. 90837 - Psychotherapy, 60 minutes with patient

4. 90839 - Psychotherapy for crisis, first 60 minutes

5. 90840 - Psychotherapy for crisis, each additional 30 minutes

6. 90846 - Family psychotherapy (without the patient present)

7. 90847 - Family psychotherapy (conjoint psychotherapy) (with patient present)

8. 90853 - Group psychotherapy (other than of a multiple-family group)

9. 96130 - Psychological testing evaluation services by a physician or other qualified healthcare professional, first hour

10. 96131 - Psychological testing evaluation services, each additional hour

11. 96136 - Psychological or neuropsychological test administration and scoring, two or more tests, any method, first 30 minutes

12. 96137 - Psychological or neuropsychological test administration and scoring, each additional 30 minutes

These CPT codes are commonly used for the treatment and management of conditions associated with ICD code F43.10. Healthcare providers should ensure accurate documentation and coding to optimize reimbursement and compliance.

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