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ICD-10 Guide
DiagnosesAdhd Combined Type

Adhd Combined Type

ICD-10 Coding for ADHD Combined Type(F90.2)

PRIMARY SPECIALTYPediatrics
COMPLEXITYHigh
LAST UPDATED09/08/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Adhd Combined Type?
Essential facts and insights about ADHD Combined Type

Key Clinical Considerations:

  • Inattention: Difficulty sustaining attention, careless mistakes, difficulty organizing tasks, and forgetfulness in daily activities.
  • Hyperactivity: Fidgeting, inability to stay seated, running or climbing in inappropriate situations, and talking excessively.
  • Impulsivity: Interrupting others, difficulty waiting for one's turn, and blurting out answers before questions have been completed.
  • Symptoms must be present in two or more settings (e.g., home, school, work).
  • Symptoms must interfere with or reduce the quality of social, academic, or occupational functioning.

Clinical Information

Clinical Criteria & Documentation Requirements

  • Document the presence of symptoms in multiple settings (e.g., home and school).
  • Use specific terminology such as 'combined type' to describe the diagnosis.
  • Include examples of behaviors that meet the criteria for inattention, hyperactivity, and impulsivity.
  • Document medical necessity for treatment, including the impact of symptoms on daily functioning.
  • Quality measures may include assessments of symptom severity and functional impairment.

Coding Guidelines

Usage Guidelines & Examples

  • Use F90.2 when a patient exhibits symptoms of both inattention and hyperactivity/impulsivity.
  • Do not use this code if symptoms are predominantly inattention (F90.0) or predominantly hyperactive-impulsive (F90.1).
  • Compare with F90.0 (ADHD, Predominantly Inattentive Type) and F90.1 (ADHD, Predominantly Hyperactive-Impulsive Type).
  • Common coding errors include misclassifying the type of ADHD based on symptom presentation.
  • In complex cases, ensure that all symptoms are documented and that the diagnosis aligns with the clinical presentation.

Code Exclusions

Important Exclusions

  • Excludes conditions such as Autism Spectrum Disorder (F84.0) and specific learning disorders (F81.x).
  • Alternative codes for excluded conditions include F84.0 for Autism and F81.x for learning disorders.
  • Conditions are excluded due to distinct diagnostic criteria and treatment approaches.
  • Common exclusion mistakes include misdiagnosing ADHD in the presence of primary mood or anxiety disorders.
  • Related but distinct conditions include mood disorders and anxiety disorders that may mimic ADHD symptoms.

Related ICD-10 Codes

Primary Codes
F90.2
ADHD Combined Type
F90.0
ADHD Predominantly Inattentive Type
Ancillary Codes
Z00.121
96127
Differential Codes
F90.0
F90.1

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Pediatrics

Specialty Applications

  • ADHD Combined Type applies to children and adolescents, but can also be diagnosed in adults.
  • Patient populations may include those with a family history of ADHD or related disorders.
  • Clinical settings include outpatient mental health clinics, pediatric practices, and school-based health services.
  • Specialty-specific applications may involve pediatricians, child psychologists, and psychiatrists.
  • Treatment contexts include behavioral therapy, medication management, and educational interventions.

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Template 1

Template: 'Patient diagnosed with ADHD Combined Type based on clinical findings of inattention and hyperactivity.'

Template 2

Template: 'Clinical presentation consistent with ADHD Combined Type including symptoms of inattention, hyperactivity, and impulsivity.'

Template 3

Template: 'Diagnostic criteria for ADHD Combined Type met as evidenced by symptoms present in multiple settings.'

Template 4

Template: 'Treatment plan initiated for ADHD Combined Type with behavioral therapy and medication management.'

Template 5

Template: 'Follow-up care for ADHD Combined Type including monitoring of symptoms and treatment efficacy.'

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What documentation is required for this diagnosis?

Documentation must include a comprehensive assessment of symptoms across multiple settings, including specific examples of inattention and hyperactivity.

How does this differ from similar diagnoses?

ADHD Combined Type includes both inattention and hyperactivity/impulsivity, while other types focus on one or the other.

What are common billing considerations?

Ensure that the diagnosis is clearly documented and that treatment plans align with the documented symptoms for optimal reimbursement.

What procedures are typically associated?

Commonly associated CPT codes include 96127 for behavioral assessment and 99213 for office visits.

Are there any quality reporting implications?

Quality measures may include tracking symptom severity and functional outcomes, which are essential for ongoing treatment evaluation.