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ICD-10 Guide
ICD-10 CodesF06.3

F06.3

Billable

Mood disorder due to known physiological condition

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

Code Description

ICD-10 F06.3 is a billable code used to indicate a diagnosis of mood disorder due to known physiological condition.

Key Diagnostic Point:

Mood disorder due to known physiological condition is characterized by the presence of mood disturbances that are directly attributable to a physiological condition. This can include a variety of medical issues such as neurological disorders, endocrine dysfunctions, or chronic illnesses that affect the brain's chemistry and functioning. Patients may exhibit symptoms such as persistent sadness, irritability, or mood swings that are not solely due to a primary psychiatric disorder but are instead a direct result of the underlying medical condition. The diagnosis requires careful evaluation to establish a clear link between the physiological condition and the mood disorder, ensuring that the mood symptoms are not better explained by other psychiatric diagnoses. Treatment typically involves addressing the underlying medical condition while also providing psychological support and, if necessary, pharmacological interventions to manage mood symptoms.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between primary mood disorders and those secondary to physiological conditions.
  • Need for comprehensive documentation linking the mood disorder to the physiological condition.
  • Potential overlap with other mental health diagnoses, requiring careful clinical assessment.
  • Variability in symptoms based on the underlying physiological condition.

Audit Risk Factors

  • Inadequate documentation linking mood symptoms to the physiological condition.
  • Failure to rule out primary psychiatric disorders.
  • Misclassification of the mood disorder as primary rather than secondary.
  • Lack of interdisciplinary notes from both mental health and medical providers.

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed psychiatric evaluation notes linking mood symptoms to the physiological condition.

Common Clinical Scenarios

Patients with chronic illnesses such as diabetes or cancer presenting with depressive symptoms.

Billing Considerations

Consideration of the patient's overall treatment plan, including both psychiatric and medical interventions.

Neurology

Documentation Requirements

Neurological assessments that detail the physiological condition affecting mood.

Common Clinical Scenarios

Patients with neurological disorders such as multiple sclerosis or traumatic brain injury exhibiting mood changes.

Billing Considerations

Collaboration with psychiatric services to address mood symptoms effectively.

Coding Guidelines

Inclusion Criteria

Use F06.3 When
  • According to ICD
  • 10 coding guidelines, F06
  • 3 should be used when mood disturbances are directly linked to a known physiological condition
  • Coders must ensure that the documentation clearly supports this connection and that other potential psychiatric diagnoses are ruled out

Exclusion Criteria

Do NOT use F06.3 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

90791CPT Code

Psychiatric diagnostic evaluation

Clinical Scenario

Used when evaluating a patient with mood disorder due to a physiological condition.

Documentation Requirements

Comprehensive evaluation notes detailing the patient's history and current symptoms.

Specialty Considerations

Psychiatrists should ensure that the evaluation includes a thorough medical history.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of mood disorders related to physiological conditions, improving the accuracy of diagnoses and treatment plans. It emphasizes the need for clear documentation of the relationship between medical conditions and mood symptoms.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of mood disorders related to physiological conditions, improving the accuracy of diagnoses and treatment plans. It emphasizes the need for clear documentation of the relationship between medical conditions and mood symptoms.

Reimbursement & Billing Impact

reimbursement.

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

What is the difference between F06.3 and primary mood disorders?

F06.3 is specifically used when mood disorders are secondary to known physiological conditions, whereas primary mood disorders are diagnosed independently of any medical conditions.