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v1.0.0
ICD-10 Guide
ICD-10 CodesF42.9

F42.9

Billable

Obsessive-compulsive disorder, unspecified

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

Code Description

ICD-10 F42.9 is a billable code used to indicate a diagnosis of obsessive-compulsive disorder, unspecified.

Key Diagnostic Point:

Obsessive-Compulsive Disorder (OCD) is a chronic mental health condition characterized by persistent, unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that the individual feels driven to perform. The obsessions often lead to significant anxiety, and the compulsions are performed in an attempt to reduce this anxiety or prevent a feared event. The unspecified designation indicates that the specific nature of the obsessions and compulsions is not clearly defined or documented. Patients may experience varying degrees of severity, and the disorder can significantly impair daily functioning. Treatment typically involves a combination of cognitive-behavioral therapy (CBT), particularly exposure and response prevention (ERP), and pharmacotherapy, such as selective serotonin reuptake inhibitors (SSRIs). Accurate coding is essential for appropriate treatment planning and insurance reimbursement, as OCD can co-occur with other anxiety disorders, PTSD, and phobias, complicating the clinical picture.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in symptom presentation and severity
  • Overlap with other anxiety disorders
  • Need for comprehensive documentation to support diagnosis
  • Potential for co-morbid conditions

Audit Risk Factors

  • Insufficient documentation of symptoms
  • Failure to document co-morbid conditions
  • Inconsistent coding across visits
  • Lack of treatment plan documentation

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed patient history, symptom description, treatment plan, and follow-up notes.

Common Clinical Scenarios

Initial diagnosis of OCD, treatment adjustments, and management of co-morbid anxiety disorders.

Billing Considerations

Ensure that all symptoms are documented clearly to support the diagnosis and treatment plan.

Psychology

Documentation Requirements

Comprehensive psychological assessments, therapy notes, and progress reports.

Common Clinical Scenarios

Cognitive-behavioral therapy sessions focusing on exposure and response prevention.

Billing Considerations

Document specific therapeutic techniques used and patient responses to treatment.

Coding Guidelines

Inclusion Criteria

Use F42.9 When
  • According to the ICD
  • CM coding guidelines, F42
  • 9 should be used when the specific type of OCD is not documented
  • Coders should ensure that the diagnosis is supported by clinical documentation and that any co
  • morbid conditions are also coded appropriately

Exclusion Criteria

Do NOT use F42.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

90834CPT Code

Psychotherapy, 45 minutes with patient

Clinical Scenario

Used for therapy sessions focusing on OCD management.

Documentation Requirements

Session notes detailing the therapeutic approach and patient progress.

Specialty Considerations

Psychiatrists and psychologists should document specific interventions used during therapy.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of OCD, improving the ability to capture the nuances of the disorder and its treatment. This specificity aids in better understanding and management of the condition.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of OCD, improving the ability to capture the nuances of the disorder and its treatment. This specificity aids in better understanding and management of the condition.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of OCD, improving the ability to capture the nuances of the disorder and its treatment. This specificity aids in better understanding and management of the condition.

Resources

Clinical References

  • •
    American Psychiatric Association - DSM-5

Coding & Billing References

  • •
    American Psychiatric Association - DSM-5

Frequently Asked Questions

What is the difference between OCD and obsessive-compulsive personality disorder?

OCD is characterized by unwanted obsessions and compulsions that cause distress, while obsessive-compulsive personality disorder involves a chronic preoccupation with orderliness and perfectionism, without the same level of distress or impairment.