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v1.0.0
ICD-10 Guide
ICD-10 CodesF84.0

F84.0

Billable

Autistic disorder

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

Code Description

ICD-10 F84.0 is a billable code used to indicate a diagnosis of autistic disorder.

Key Diagnostic Point:

Autistic disorder, classified under the broader category of autism spectrum disorders (ASD), is a complex neurodevelopmental condition characterized by persistent deficits in social communication and interaction across multiple contexts, alongside restricted, repetitive patterns of behavior, interests, or activities. Symptoms typically manifest in early childhood and can significantly impact daily functioning. Individuals with autistic disorder may exhibit challenges in understanding social cues, engaging in reciprocal conversations, and forming relationships. Additionally, they may display repetitive movements, insistence on sameness, and heightened sensitivity to sensory input. The severity of symptoms can vary widely, leading to a spectrum of functioning levels, from those requiring substantial support to those who may function independently. Diagnosis is primarily based on clinical observation and developmental history, with standardized assessment tools often employed to evaluate the severity and impact of symptoms. Early intervention and tailored therapeutic approaches can improve outcomes, emphasizing the importance of accurate coding for appropriate resource allocation and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in symptom presentation and severity among patients
  • Need for comprehensive documentation of developmental history
  • Differentiation from other neurodevelopmental disorders
  • Potential for co-occurring conditions that complicate diagnosis

Audit Risk Factors

  • Inadequate documentation of social communication deficits
  • Failure to note co-occurring conditions
  • Misclassification of severity level
  • Lack of evidence for developmental history

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed developmental milestones, behavioral assessments, and family history.

Common Clinical Scenarios

Routine developmental screenings, referrals for behavioral therapy, and multidisciplinary evaluations.

Billing Considerations

Consideration of age-appropriate behaviors and cultural factors influencing development.

Psychiatry

Documentation Requirements

Comprehensive psychiatric evaluations, including mental status exams and psychosocial assessments.

Common Clinical Scenarios

Diagnosis confirmation, medication management, and therapy referrals.

Billing Considerations

Need for ongoing assessment of comorbid psychiatric conditions.

Coding Guidelines

Inclusion Criteria

Use F84.0 When
  • According to ICD
  • 10 guidelines, F84
  • 0 should be used when there is clear evidence of autistic disorder as defined by the DSM
  • 5 criteria

Exclusion Criteria

Do NOT use F84.0 When
  • Exclusion criteria include other neurodevelopmental disorders that may present similarly but require different coding

Related ICD-10 Codes

Related CPT Codes

96110CPT Code

Developmental screening, with interpretation and report

Clinical Scenario

Used during routine pediatric visits to assess developmental milestones.

Documentation Requirements

Document the screening results and any referrals made.

Specialty Considerations

Pediatricians should ensure comprehensive developmental assessments are performed.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of autism spectrum disorders, improving the accuracy of diagnoses and treatment planning. F84.0 provides a clear designation for autistic disorder, facilitating better resource allocation and care management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of autism spectrum disorders, improving the accuracy of diagnoses and treatment planning. F84.0 provides a clear designation for autistic disorder, facilitating better resource allocation and care management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of autism spectrum disorders, improving the accuracy of diagnoses and treatment planning. F84.0 provides a clear designation for autistic disorder, facilitating better resource allocation and care management.

Resources

Clinical References

  • •
    CDC Autism Spectrum Disorder

Coding & Billing References

  • •
    CDC Autism Spectrum Disorder

Frequently Asked Questions

What is the difference between F84.0 and F84.1?

F84.0 refers to autistic disorder with significant communication deficits, while F84.1 refers to Asperger's syndrome, which is characterized by milder symptoms and no significant language delay.