ICD Code F43.23

ICD code F43.23 is used to identify an adjustment disorder characterized by a combination of anxiety and depressive symptoms. This code is applied when a patient experiences emotional or behavioral symptoms in response to a specific stressor, and these symptoms include both anxiety and depression, but do not meet the criteria for a more specific mood or anxiety disorder. This code helps healthcare providers document and communicate the nature of the patient's condition for treatment planning and insurance purposes.

1. Presence of Stressor: The individual must have experienced a significant life stressor or a series of stressors. These stressors can be identifiable events such as a major life change, trauma, or ongoing difficulties.

2. Onset of Symptoms: Symptoms must develop within three months of the onset of the stressor. The timing is crucial to differentiate from other mental health conditions that may have a different onset pattern.

3. Mixed Symptoms: The individual exhibits both anxiety and depressive symptoms. This includes feelings of nervousness, worry, jitteriness, and apprehension, alongside feelings of sadness, hopelessness, and a lack of interest in activities.

4. 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.

5. Exclusion of Other Disorders: The symptoms should not meet the criteria for another mental disorder and are not merely an exacerbation of a pre-existing mental disorder.

6. Resolution of Symptoms: Once the stressor or its consequences have terminated, the symptoms do not persist for more than an additional six months. If symptoms continue beyond this period, a different diagnosis may be considered.

7. Cultural Context: The reaction to the stressor is considered excessive when compared to what would be expected given the individual's cultural context and norms.

For the ICD code F43.23, which is associated with adjustment disorder with mixed anxiety and 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)

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

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 commonly used in the context of mental health services and can be billed for various therapeutic interventions related to the treatment of adjustment disorders. 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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