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ICD-10 Guide
ICD-10 CodesF45.0

F45.0

Billable

Somatization disorder

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

Code Description

ICD-10 F45.0 is a billable code used to indicate a diagnosis of somatization disorder.

Key Diagnostic Point:

Somatization disorder, classified under ICD-10 code F45.0, is characterized by the presence of multiple, recurrent, and frequently changing physical symptoms that cannot be fully explained by a medical condition. Patients often experience significant distress and impairment in social, occupational, or other important areas of functioning. The symptoms may include pain, gastrointestinal issues, and neurological complaints, which lead to extensive medical evaluations and treatments. The disorder is often associated with psychological factors, including anxiety and depression, and may co-occur with other mental health conditions such as anxiety disorders, PTSD, and OCD. Effective management typically involves a multidisciplinary approach, including psychotherapy, cognitive-behavioral therapy, and sometimes pharmacotherapy to address underlying anxiety or mood disorders. Understanding the interplay between psychological and physical symptoms is crucial for accurate diagnosis and treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in symptom presentation
  • Overlap with other mental health disorders
  • Need for comprehensive documentation
  • Potential for misdiagnosis

Audit Risk Factors

  • Inadequate documentation of symptom severity
  • Failure to document the impact on daily functioning
  • Lack of evidence for psychological evaluation
  • Misalignment between diagnosis and treatment provided

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed patient history, including psychological evaluations and symptom descriptions.

Common Clinical Scenarios

Patients presenting with unexplained physical symptoms alongside anxiety or mood disorders.

Billing Considerations

Ensure clear documentation of the relationship between psychological factors and physical symptoms.

Primary Care

Documentation Requirements

Comprehensive medical history and physical examination findings.

Common Clinical Scenarios

Patients with multiple visits for physical complaints without clear medical diagnoses.

Billing Considerations

Document all referrals to mental health specialists and any treatments initiated.

Coding Guidelines

Inclusion Criteria

Use F45.0 When
  • According to ICD
  • 10 coding guidelines, F45
  • 0 should be used when a patient presents with multiple physical complaints that cannot be attributed to a medical condition
  • Documentation must support the diagnosis, including the duration of symptoms and their impact on the patient's life

Exclusion Criteria

Do NOT use F45.0 When
  • Exclusion criteria include conditions that can fully explain the symptoms

Related ICD-10 Codes

Related CPT Codes

90834CPT Code

Psychotherapy, 45 minutes with patient

Clinical Scenario

Used for patients with somatization disorder receiving therapy.

Documentation Requirements

Document the duration of the session and the therapeutic interventions used.

Specialty Considerations

Psychiatrists should ensure that the treatment plan aligns with the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of somatization disorder, improving the ability to capture the complexity of the condition and its relationship with other mental health disorders. This specificity aids in better treatment planning and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of somatization disorder, improving the ability to capture the complexity of the condition and its relationship with other mental health disorders. This specificity aids in better treatment planning and resource allocation.

Reimbursement & Billing Impact

impact on daily functioning. Providers should ensure that treatment plans are well-documented and that any referrals to specialists are noted.

Resources

Clinical References

  • •
    American Psychiatric Association - Diagnostic and Statistical Manual of Mental Disorders

Coding & Billing References

  • •
    American Psychiatric Association - Diagnostic and Statistical Manual of Mental Disorders

Frequently Asked Questions

What is the primary treatment for somatization disorder?

The primary treatment for somatization disorder often involves psychotherapy, particularly cognitive-behavioral therapy, which helps patients understand the connection between their thoughts, feelings, and physical symptoms. In some cases, medication may be prescribed to manage co-occurring anxiety or depression.