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ICD-10 Guide
ICD-10 CodesF06.34

F06.34

Billable

Mood disorder due to known physiological condition with mixed features

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

Code Description

ICD-10 F06.34 is a billable code used to indicate a diagnosis of mood disorder due to known physiological condition with mixed features.

Key Diagnostic Point:

F06.34 refers to mood disorders that arise as a direct result of a known physiological condition. This includes mood disturbances that may present with mixed features, such as symptoms of both depression and mania. These disorders can occur due to various medical conditions, including neurological disorders, endocrine disorders, or chronic illnesses that affect brain function and mood regulation. The mixed features aspect indicates that the patient may exhibit symptoms of both depressive and manic episodes simultaneously, complicating the clinical picture. Accurate diagnosis requires a thorough assessment of the patient's medical history, current physiological conditions, and a detailed evaluation of mood symptoms. It is crucial to differentiate these mood disorders from primary mood disorders, as the treatment approach may differ significantly based on the underlying physiological cause.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires comprehensive understanding of both psychiatric and physiological conditions.
  • Differentiation from primary mood disorders can be challenging.
  • Documentation must clearly link mood symptoms to the physiological condition.
  • Mixed features complicate the clinical picture and coding.

Audit Risk Factors

  • Insufficient documentation linking mood symptoms to the physiological condition.
  • Failure to document mixed features appropriately.
  • Inconsistent coding practices across different providers.
  • Lack of interdisciplinary communication in patient care.

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed psychiatric evaluation, including mood assessments and history of physiological conditions.

Common Clinical Scenarios

Patients with chronic illnesses presenting with mood changes, such as those with cancer or neurological disorders.

Billing Considerations

Need to document the interplay between physiological conditions and mood symptoms clearly.

Neurology

Documentation Requirements

Neurological assessments, imaging results, and correlation of neurological findings with mood symptoms.

Common Clinical Scenarios

Patients with traumatic brain injury or neurodegenerative diseases exhibiting mood disorders.

Billing Considerations

Collaboration with psychiatry for comprehensive care and accurate coding.

Coding Guidelines

Inclusion Criteria

Use F06.34 When
  • According to ICD
  • 10 guidelines, F06
  • 34 should be used when mood disturbances are directly attributable to a known physiological condition
  • Documentation must clearly establish this link, and mixed features must be explicitly noted

Exclusion Criteria

Do NOT use F06.34 When
  • Exclusion criteria include primary mood disorders that are not secondary to physiological conditions

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 history and mental status examination.

Specialty Considerations

Psychiatric evaluations must include details of the physiological condition.

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. F06.34 provides a clear framework for identifying and managing these complex cases.

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. F06.34 provides a clear framework for identifying and managing these complex cases.

Reimbursement & Billing Impact

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. F06.34 provides a clear framework for identifying and managing these complex cases.

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 are the key symptoms of mood disorder due to known physiological condition?

Key symptoms include persistent mood changes, irritability, and fluctuations between depressive and manic states, all linked to an underlying medical condition.