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ICD-10 Guide
ICD-10 CodesF84.5

F84.5

Billable

Asperger's syndrome

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

Code Description

ICD-10 F84.5 is a billable code used to indicate a diagnosis of asperger's syndrome.

Key Diagnostic Point:

Asperger's syndrome is a neurodevelopmental disorder that falls within the autism spectrum disorders (ASD). It is characterized by significant difficulties in social interaction, alongside restricted and repetitive patterns of behavior and interests. Individuals with Asperger's syndrome typically exhibit average to above-average intelligence and may have strong verbal skills, but they often struggle with non-verbal communication cues, such as body language and facial expressions. Common features include a lack of empathy, difficulty in understanding social norms, and a tendency to focus intensely on specific interests. Unlike other forms of autism, individuals with Asperger's do not exhibit significant delays in language development, which can lead to challenges in diagnosis. The condition can impact educational performance and social relationships, necessitating tailored interventions and support strategies. Early diagnosis and intervention are crucial for improving outcomes and helping individuals develop coping strategies for their challenges.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in symptom presentation among individuals
  • Overlap with other autism spectrum disorders
  • Need for comprehensive documentation of social and communication deficits
  • Potential for co-occurring conditions (e.g., ADHD, anxiety disorders)

Audit Risk Factors

  • Inadequate documentation of social and communication challenges
  • Failure to document co-occurring conditions
  • Misdiagnosis or incorrect coding due to symptom overlap
  • Lack of evidence for the impact of the disorder on daily functioning

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed assessment of social skills, communication abilities, and behavioral patterns.

Common Clinical Scenarios

Evaluating a child with social withdrawal and intense interests; assessing an adult seeking support for workplace challenges.

Billing Considerations

Consideration of co-occurring mental health conditions and their impact on treatment.

Pediatrics

Documentation Requirements

Developmental history, parental observations, and school performance evaluations.

Common Clinical Scenarios

Identifying a child with social difficulties in school; monitoring developmental milestones.

Billing Considerations

Collaboration with educational professionals for comprehensive support.

Coding Guidelines

Inclusion Criteria

Use F84.5 When
  • According to ICD
  • 10 guidelines, F84
  • 5 should be used when the individual meets the criteria for Asperger's syndrome, including persistent deficits in social communication and interaction, along with restricted, repetitive patterns of behavior
  • Documentation must support the diagnosis and detail the impact on functioning

Exclusion Criteria

Do NOT use F84.5 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

96110CPT Code

Developmental screening, with interpretation and report, per standardized instrument

Clinical Scenario

Used during initial evaluations for children suspected of having Asperger's syndrome.

Documentation Requirements

Documentation of the screening tool used and results.

Specialty Considerations

Pediatricians should ensure comprehensive developmental assessments are included.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of Asperger's syndrome, reflecting the nuanced understanding of autism spectrum disorders. This specificity aids in better tracking of prevalence and resource allocation for affected individuals.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of Asperger's syndrome, reflecting the nuanced understanding of autism spectrum disorders. This specificity aids in better tracking of prevalence and resource allocation for affected individuals.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of Asperger's syndrome, reflecting the nuanced understanding of autism spectrum disorders. This specificity aids in better tracking of prevalence and resource allocation for affected individuals.

Resources

Clinical References

  • •
    Autism Spectrum Disorder: A Guide for Families

Coding & Billing References

  • •
    Autism Spectrum Disorder: A Guide for Families

Frequently Asked Questions

What is the difference between Asperger's syndrome and other autism spectrum disorders?

Asperger's syndrome is characterized by milder symptoms and no significant delays in language development, unlike other forms of autism which may present with more severe communication deficits and developmental delays.