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v1.0.0
ICD-10 Guide
ICD-10 CodesF43.11

F43.11

Billable

Post-traumatic stress disorder, acute

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

Code Description

ICD-10 F43.11 is a billable code used to indicate a diagnosis of post-traumatic stress disorder, acute.

Key Diagnostic Point:

Post-traumatic stress disorder (PTSD) is a mental health condition triggered by experiencing or witnessing a traumatic event. Acute PTSD, as denoted by the ICD-10 code F43.11, occurs within the first three months following the trauma. Symptoms may include intrusive memories, flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event. Individuals may also experience emotional numbness, avoidance of reminders of the trauma, and heightened arousal, such as difficulty sleeping or concentrating. The acute phase of PTSD can significantly impair daily functioning and quality of life. Diagnosis is based on clinical assessment, including the duration and severity of symptoms, and must meet specific criteria outlined in the DSM-5. Treatment often involves psychotherapy, such as cognitive-behavioral therapy (CBT), and may include medication to manage anxiety and depression. Early intervention is crucial for improving outcomes and preventing the progression to chronic PTSD.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between acute and chronic PTSD
  • Understanding the specific time frame for acute symptoms
  • Recognizing overlapping symptoms with other anxiety disorders
  • Documentation requirements for trauma history

Audit Risk Factors

  • Inadequate documentation of trauma history
  • Failure to specify acute versus chronic PTSD
  • Misclassification of symptoms overlapping with other disorders
  • Lack of follow-up documentation on treatment response

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Comprehensive mental health assessment, including trauma history and symptom severity.

Common Clinical Scenarios

Initial evaluation of a patient presenting with PTSD symptoms after a recent traumatic event.

Billing Considerations

Ensure that all symptoms are documented clearly to support the diagnosis of acute PTSD.

Primary Care

Documentation Requirements

Detailed patient history, including psychosocial factors and any referrals to mental health specialists.

Common Clinical Scenarios

Patients presenting with anxiety and stress-related symptoms following a traumatic incident.

Billing Considerations

Recognize the importance of screening for PTSD in patients with trauma exposure.

Coding Guidelines

Inclusion Criteria

Use F43.11 When
  • Follow the ICD
  • CM coding guidelines for mental health disorders, ensuring that the diagnosis is supported by clinical documentation
  • Acute PTSD must be diagnosed within three months of the traumatic event

Exclusion Criteria

Do NOT use F43.11 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 focused on managing PTSD symptoms.

Documentation Requirements

Document the duration of the session and specific therapeutic techniques used.

Specialty Considerations

Psychiatrists should note the patient's progress and response to therapy.

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 acute cases and improving treatment outcomes through targeted interventions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of PTSD, enabling better tracking of acute cases and improving treatment outcomes through targeted interventions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of PTSD, enabling better tracking of acute cases and improving treatment outcomes through targeted interventions.

Resources

Clinical References

  • •
    National Center for PTSD

Coding & Billing References

  • •
    National Center for PTSD

Frequently Asked Questions

What is the difference between acute and chronic PTSD?

Acute PTSD occurs within three months of a traumatic event, while chronic PTSD persists for more than three months. The symptoms and treatment approaches may vary based on the duration and severity of the condition.