ICD Code F43.21

ICD code F43.21 is used to identify a diagnosis of adjustment disorder with depressed mood. This condition occurs when an individual experiences emotional or behavioral symptoms in response to a specific stressor, leading to feelings of depression. The symptoms are typically more severe than what would be expected in response to the stressor and can significantly impact daily functioning. This code helps healthcare providers document and communicate the specific nature of the patient's adjustment disorder for treatment planning and insurance purposes.

1. Emotional Disturbance Following a Stressor: The individual must have experienced a significant emotional or behavioral disturbance in response to an identifiable stressor. This stressor can be a single event or multiple events, and it should have occurred within the past three months.

2. Depressed Mood: The primary symptom should be a depressed mood, which may include feelings of sadness, hopelessness, or a lack of interest in previously enjoyable activities.

3. Functional Impairment: The symptoms must cause significant impairment in social, occupational, or other important areas of functioning. This could manifest as difficulties at work, in relationships, or in daily activities.

4. Exclusion of Other Disorders: The symptoms should not meet the criteria for another mental disorder, such as major depressive disorder or generalized anxiety disorder. The diagnosis should be specific to the adjustment disorder context.

5. Non-Prolonged Duration: The symptoms should not persist for more than six months after the stressor or its consequences have ceased. If symptoms continue beyond this period, a different diagnosis may be considered.

6. Cultural Context Consideration: The reaction should be considered excessive or disproportionate to the stressor when taking into account cultural, social, and contextual factors.

7. Absence of Bereavement: The symptoms should not be better explained by normal bereavement, which has its own diagnostic criteria and considerations.

For the ICD code F43.21, which is associated with adjustment disorder with depressed mood, 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. 99201-99215 - Evaluation and management services, which may be used if the treatment involves a medical evaluation component

These CPT codes are typically used by mental health professionals to bill for services provided to patients diagnosed with adjustment disorder with depressed mood. It's important for healthcare providers to select the appropriate CPT code based on the specific services rendered and the time spent with the patient.

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