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ICD-10 Guide
ICD-10 CodesF84.3

F84.3

Billable

Other childhood disintegrative disorder

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

Code Description

ICD-10 F84.3 is a billable code used to indicate a diagnosis of other childhood disintegrative disorder.

Key Diagnostic Point:

Other childhood disintegrative disorder, also known as Heller's syndrome, is a rare neurodevelopmental disorder characterized by a significant regression in multiple areas of functioning after at least two years of normal development. This condition typically manifests in children between the ages of 2 and 4 years, where they may lose previously acquired skills in language, social interaction, and motor abilities. Unlike autism spectrum disorders, children with disintegrative disorder experience a more profound and rapid decline in functioning. Symptoms may include a loss of social engagement, communication skills, and the ability to perform daily activities. The etiology of this disorder is not well understood, but it is believed to involve a combination of genetic and environmental factors. Diagnosis is primarily clinical, based on observed developmental regression and the exclusion of other conditions. Early intervention is crucial for improving outcomes, and treatment often involves a multidisciplinary approach, including behavioral therapy, speech therapy, and educational support.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating from other neurodevelopmental disorders such as autism spectrum disorder.
  • Need for comprehensive documentation of developmental history and regression.
  • Variability in symptom presentation among affected children.
  • Potential overlap with other conditions leading to misdiagnosis.

Audit Risk Factors

  • Inadequate documentation of developmental history.
  • Failure to document the timeline of skill regression.
  • Misclassification of the disorder as autism spectrum disorder.
  • Lack of comprehensive assessments from multidisciplinary teams.

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed developmental history, including milestones and regression timeline.

Common Clinical Scenarios

Assessment of a child presenting with sudden loss of language and social skills.

Billing Considerations

Need for collaboration with speech and occupational therapists for comprehensive evaluation.

Psychiatry

Documentation Requirements

Psychiatric evaluation notes detailing behavioral changes and regression.

Common Clinical Scenarios

Evaluation of a child with behavioral issues and loss of previously acquired skills.

Billing Considerations

Consideration of comorbid mental health conditions that may complicate diagnosis.

Coding Guidelines

Inclusion Criteria

Use F84.3 When
  • According to ICD
  • 10 coding guidelines, F84
  • 3 should be used when there is clear evidence of developmental regression after a period of normal development
  • Coders must ensure that the diagnosis is supported by thorough documentation of the child's developmental milestones and the specific skills that have been lost

Exclusion Criteria

Do NOT use F84.3 When
  • Exclusion criteria include other neurodevelopmental disorders that do not fit the criteria for disintegrative disorder

Related ICD-10 Codes

Related CPT Codes

96110CPT Code

Developmental screening, with interpretation and report

Clinical Scenario

Used during initial assessments of children suspected of having developmental disorders.

Documentation Requirements

Documentation of the screening results and any follow-up recommendations.

Specialty Considerations

Pediatricians should ensure comprehensive developmental history is included.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of childhood disintegrative disorder, enabling better tracking of this rare condition and improving the ability to analyze treatment outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of childhood disintegrative disorder, enabling better tracking of this rare condition and improving the ability to analyze treatment outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of childhood disintegrative disorder, enabling better tracking of this rare condition and improving the ability to analyze treatment outcomes and resource allocation.

Resources

Clinical References

  • •
    American Academy of Pediatrics - Developmental Surveillance and Screening

Coding & Billing References

  • •
    American Academy of Pediatrics - Developmental Surveillance and Screening

Frequently Asked Questions

What are the key symptoms of other childhood disintegrative disorder?

Key symptoms include significant regression in language, social skills, and motor abilities after a period of normal development, typically observed between ages 2 and 4.

How is other childhood disintegrative disorder diagnosed?

Diagnosis is primarily clinical, based on observed developmental regression and the exclusion of other neurodevelopmental disorders. A thorough developmental history and assessment are essential.