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v1.0.0
ICD-10 Guide
ICD-10 CodesF43.10

F43.10

Billable

Post-traumatic stress disorder, unspecified

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

Code Description

ICD-10 F43.10 is a billable code used to indicate a diagnosis of post-traumatic stress disorder, unspecified.

Key Diagnostic Point:

Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after an individual has experienced or witnessed a traumatic event. Symptoms may include intrusive thoughts, flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event. Individuals may also experience avoidance behaviors, emotional numbness, and hyperarousal, which can manifest as irritability, difficulty sleeping, and heightened startle responses. The unspecified designation indicates that the clinician has determined the presence of PTSD but has not specified the type or severity of the symptoms. This code is often used when the clinician has not yet fully assessed the patient's condition or when the symptoms do not fit neatly into other specified categories of PTSD. Effective management of PTSD often involves a combination of psychotherapy, medication, and support from family and friends. Cognitive-behavioral therapy (CBT) and exposure therapy are commonly used therapeutic approaches, while medications such as SSRIs may be prescribed to help alleviate symptoms.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in symptom presentation among patients
  • Need for comprehensive documentation to support diagnosis
  • Potential overlap with other anxiety disorders
  • Changes in diagnostic criteria over time

Audit Risk Factors

  • Inadequate documentation of trauma history
  • Failure to specify symptom duration
  • Lack of evidence for treatment plans
  • Misclassification of PTSD severity

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed patient history, including trauma exposure and symptomatology.

Common Clinical Scenarios

Patients presenting with anxiety, depression, or behavioral issues following trauma.

Billing Considerations

Ensure comprehensive documentation of all symptoms and treatment plans to support the diagnosis.

Primary Care

Documentation Requirements

Thorough assessment of mental health status and referral notes if applicable.

Common Clinical Scenarios

Patients with unexplained physical symptoms that may be linked to PTSD.

Billing Considerations

Primary care providers should be aware of the signs of PTSD and document any referrals to mental health specialists.

Coding Guidelines

Inclusion Criteria

Use F43.10 When
  • According to the ICD
  • 10 coding guidelines, PTSD is classified under anxiety disorders
  • The unspecified code should be used when the clinician has not specified the type or severity of PTSD
  • Documentation must support the diagnosis, including a clear description of the traumatic event and the patient's symptoms

Exclusion Criteria

Do NOT use F43.10 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 addressing PTSD symptoms.

Documentation Requirements

Session notes detailing patient progress and treatment focus.

Specialty Considerations

Psychiatrists should document specific therapeutic techniques used.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of PTSD, enabling better tracking of the condition and its treatment. The introduction of unspecified codes provides flexibility in cases where full assessment is pending.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of PTSD, enabling better tracking of the condition and its treatment. The introduction of unspecified codes provides flexibility in cases where full assessment is pending.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of PTSD, enabling better tracking of the condition and its treatment. The introduction of unspecified codes provides flexibility in cases where full assessment is pending.

Resources

Clinical References

  • •
    National Center for PTSD

Coding & Billing References

  • •
    National Center for PTSD

Frequently Asked Questions

What is the difference between F43.10 and F43.11?

F43.10 is used when PTSD is unspecified, while F43.11 is for acute PTSD, which has specific criteria regarding symptom duration and severity.