ICD Code F43.12

ICD code F43.12 is used to identify and classify chronic post-traumatic stress disorder (PTSD). This code is part of the International Classification of Diseases, 10th Revision (ICD-10), which is a standardized system used globally to diagnose and categorize health conditions. Chronic PTSD, as indicated by this code, refers to a prolonged and persistent form of PTSD that occurs when symptoms last for more than three months following exposure to a traumatic event. This condition can significantly impact a patient's mental health and daily functioning, necessitating ongoing treatment and management.

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. Persistent Re-experiencing: The individual experiences persistent re-experiencing of the traumatic event. This can manifest as intrusive memories, distressing dreams, flashbacks, or intense psychological distress at exposure to cues that symbolize or resemble an aspect of the traumatic event.

3. Avoidance and Numbing: There is evidence of persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness. This may include efforts to avoid thoughts, feelings, or conversations associated with the trauma, avoiding activities, places, or people that arouse recollections of the trauma, and a marked decrease in interest or participation in significant activities.

4. Negative Alterations in Cognitions and Mood: The individual exhibits negative alterations in cognitions and mood associated with the traumatic event. This can include an inability to remember important aspects of the trauma, persistent and exaggerated negative beliefs or expectations about oneself, others, or the world, and persistent negative emotional states such as fear, horror, anger, guilt, or shame.

5. Marked Alterations in Arousal and Reactivity: There are marked alterations in arousal and reactivity associated with the traumatic event. Symptoms may include irritability or outbursts of anger, reckless or self-destructive behavior, hypervigilance, exaggerated startle response, problems with concentration, and sleep disturbances.

6. Duration: The duration of the disturbance (symptoms in Criteria 2-5) is more than one month.

7. Functional Impairment: The disturbance causes 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 F43.12, which pertains to post-traumatic stress disorder, chronic, 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), 50 minutes

7. 90847 - Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes

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 in the treatment of chronic post-traumatic stress disorder and can be part of a comprehensive treatment plan tailored to the needs of the patient. Healthcare providers should ensure that the selected CPT codes accurately reflect the services provided and are in compliance with payer requirements.

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