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ICD-10 Guide
ICD-10 CodesChapter 5: Mental, Behavioral and Neurodevelopmental disordersF69

F69

Billable

Unspecified disorder of adult personality and behavior

Chapter 5:Mental, Behavioral and Neurodevelopmental disorders

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

Code Description

ICD-10 F69 is a billable code used to indicate a diagnosis of unspecified disorder of adult personality and behavior.

Key Diagnostic Point:

F69 refers to unspecified disorders of adult personality and behavior, which encompass a range of maladaptive behaviors and personality traits that do not meet the criteria for specific personality disorders. These disorders can manifest as difficulties in interpersonal relationships, emotional regulation, and impulse control. Individuals may exhibit traits such as emotional instability, impulsivity, or maladaptive coping mechanisms that interfere with daily functioning. The lack of specificity in this code allows for the classification of various personality-related issues that do not fit neatly into established categories, such as borderline personality disorder or antisocial personality disorder. Clinicians may use this code when the patient's symptoms are significant but do not align with the diagnostic criteria of a specific disorder. This code is particularly relevant in cases where the patient's behavior is problematic but lacks sufficient detail for a more precise diagnosis, making it essential for coders to understand the nuances of personality disorders and the importance of thorough documentation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in symptom presentation among patients
  • Overlap with other mental health disorders
  • Need for comprehensive clinical documentation
  • Potential for misdiagnosis without thorough assessment

Audit Risk Factors

  • Insufficient documentation to support the diagnosis
  • Inconsistent use of the code across different providers
  • Lack of follow-up or treatment plans documented
  • Potential for upcoding if symptoms are exaggerated

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed patient history, symptom assessment, and treatment plans.

Common Clinical Scenarios

Patients presenting with emotional dysregulation, impulsivity, or interpersonal conflicts.

Billing Considerations

Ensure comprehensive documentation of symptoms and their impact on daily functioning.

Psychology

Documentation Requirements

Psychological evaluations, therapy notes, and progress reports.

Common Clinical Scenarios

Individuals seeking therapy for relationship issues or emotional instability.

Billing Considerations

Document therapeutic interventions and patient responses to treatment.

Coding Guidelines

Inclusion Criteria

Use F69 When
  • According to ICD
  • 10 guidelines, F69 should be used when the clinician determines that the patient's personality and behavior issues are significant but do not meet the criteria for a specific disorder
  • Coders should ensure that documentation supports the use of this code and that it reflects the patient's clinical picture accurately

Exclusion Criteria

Do NOT use F69 When
No specific exclusions found.

Related CPT Codes

90834CPT Code

Psychotherapy, 45 minutes with patient

Clinical Scenario

Used for therapy sessions addressing maladaptive behaviors.

Documentation Requirements

Session notes detailing patient progress and treatment goals.

Specialty Considerations

Psychiatrists and psychologists should document the therapeutic approach and patient engagement.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more nuanced coding of personality disorders, including the ability to capture unspecified disorders like F69. This has implications for treatment planning and insurance reimbursement, as it provides a broader framework for understanding complex patient presentations.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more nuanced coding of personality disorders, including the ability to capture unspecified disorders like F69. This has implications for treatment planning and insurance reimbursement, as it provides a broader framework for understanding complex patient presentations.

Reimbursement & Billing Impact

reimbursement, as it provides a broader framework for understanding complex patient presentations.

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

When should I use F69 instead of a specific personality disorder code?

F69 should be used when the patient's symptoms are significant but do not meet the criteria for a specific personality disorder. Ensure that documentation supports the use of this code.