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ICD-10 Guide
ICD-10 CodesF06.30

F06.30

Billable

Mood disorder due to known physiological condition, unspecified

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 F06.30 is a billable code used to indicate a diagnosis of mood disorder due to known physiological condition, unspecified.

Key Diagnostic Point:

F06.30 refers to mood disorders that arise as a direct consequence of a known physiological condition. These disorders can manifest in various forms, including depressive episodes, anxiety, or mood swings, and are often linked to underlying medical issues such as endocrine disorders, neurological conditions, or chronic illnesses. The mood disturbances are not primary psychiatric disorders but rather secondary to the physiological condition affecting the brain's chemistry or function. For instance, conditions like hypothyroidism, Cushing's syndrome, or traumatic brain injuries can lead to significant mood changes. The diagnosis requires careful evaluation to establish a clear link between the physiological condition and the mood disorder, ensuring that the mood symptoms are not better explained by a primary psychiatric disorder. Treatment typically involves addressing the underlying physiological condition while also providing psychiatric support to manage mood symptoms effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for comprehensive medical history to establish the link between physiological condition and mood disorder.
  • Differentiation from primary mood disorders which may require additional diagnostic criteria.
  • Potential overlap with other mental health diagnoses, complicating accurate coding.
  • Documentation must clearly indicate the physiological condition causing the mood disorder.

Audit Risk Factors

  • Insufficient documentation linking the mood disorder to the physiological condition.
  • Inconsistent use of the code across different providers.
  • Failure to update the diagnosis as the physiological condition changes.
  • Lack of clear treatment plans addressing both the physiological and mood disorders.

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed psychiatric evaluation linking mood symptoms to physiological conditions.

Common Clinical Scenarios

Patients with chronic illnesses presenting with depressive symptoms.

Billing Considerations

Consideration of medication side effects from treatments for the physiological condition.

Endocrinology

Documentation Requirements

Thorough documentation of hormonal levels and their impact on mood.

Common Clinical Scenarios

Patients with thyroid disorders exhibiting mood changes.

Billing Considerations

Need to differentiate between mood changes due to hormonal imbalances versus primary mood disorders.

Coding Guidelines

Inclusion Criteria

Use F06.30 When
  • According to ICD
  • 10 guidelines, F06
  • 30 should be used when mood disorders are clearly linked to a known physiological condition
  • Coders must ensure that the documentation supports this connection and that other potential diagnoses are ruled out

Exclusion Criteria

Do NOT use F06.30 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

Used for follow-up visits to manage mood disorders linked to physiological conditions.

Documentation Requirements

Document the patient's mood symptoms and their relation to the physiological condition.

Specialty Considerations

Psychiatrists should focus on the mental health aspects, while endocrinologists should document the physiological condition.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of mood disorders related to physiological conditions, improving the accuracy of diagnoses and treatment plans. This specificity aids in better understanding the relationship between physical and mental health.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of mood disorders related to physiological conditions, improving the accuracy of diagnoses and treatment plans. This specificity aids in better understanding the relationship between physical and mental health.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of mood disorders related to physiological conditions, improving the accuracy of diagnoses and treatment plans. This specificity aids in better understanding the relationship between physical and mental health.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between F06.30 and F06.31?

F06.30 is used for unspecified mood disorders due to physiological conditions, while F06.31 specifies depressive types of mood disorders. The choice of code depends on the documentation of the mood symptoms.