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ICD-10 Guide
ICD-10 CodesF07.9

F07.9

Billable

Unspecified personality and behavioral disorder due to known physiological condition

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

Code Description

ICD-10 F07.9 is a billable code used to indicate a diagnosis of unspecified personality and behavioral disorder due to known physiological condition.

Key Diagnostic Point:

F07.9 refers to a category of personality and behavioral disorders that arise as a direct consequence of a known physiological condition. These disorders can manifest in various ways, including changes in mood, behavior, and personality traits, which are not attributable to primary psychiatric disorders. Common physiological conditions that may lead to such disorders include neurological diseases (e.g., traumatic brain injury, stroke, or dementia), endocrine disorders (e.g., thyroid dysfunction), and metabolic conditions (e.g., hepatic encephalopathy). Clinically, patients may exhibit symptoms such as impulsivity, emotional instability, or social withdrawal, which can significantly impact their daily functioning and interpersonal relationships. Diagnosis requires a thorough assessment to rule out primary psychiatric disorders and to establish a clear link between the physiological condition and the observed behavioral changes. Treatment typically involves addressing the underlying physiological condition, along with supportive therapies aimed at managing behavioral symptoms.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between primary psychiatric disorders and secondary disorders due to physiological conditions.
  • Need for comprehensive documentation linking behavioral changes to specific physiological conditions.
  • Variability in symptoms based on the underlying condition, requiring detailed clinical assessment.
  • Potential overlap with other mental health diagnoses, necessitating careful coding.

Audit Risk Factors

  • Insufficient documentation linking the physiological condition to the behavioral disorder.
  • Inconsistent coding practices among providers.
  • Failure to specify the underlying physiological condition.
  • Lack of follow-up documentation to support ongoing treatment.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological assessments and links to behavioral changes.

Common Clinical Scenarios

Patients with traumatic brain injuries exhibiting personality changes.

Billing Considerations

Ensure that neurological evaluations are documented to support the diagnosis.

Psychiatry

Documentation Requirements

Comprehensive psychiatric evaluations and history of physiological conditions.

Common Clinical Scenarios

Patients with dementia showing changes in personality and behavior.

Billing Considerations

Document the timeline of behavioral changes in relation to the onset of the physiological condition.

Coding Guidelines

Inclusion Criteria

Use F07.9 When
  • According to ICD
  • 10 coding guidelines, F07
  • 9 should be used when there is clear evidence of a personality or behavioral disorder that is directly attributable to a known physiological condition
  • Coders must ensure that the documentation supports this link and that other potential diagnoses are ruled out

Exclusion Criteria

Do NOT use F07.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

90791CPT Code

Psychiatric diagnostic evaluation

Clinical Scenario

Used when assessing a patient with behavioral changes linked to a physiological condition.

Documentation Requirements

Comprehensive history and mental status examination.

Specialty Considerations

Ensure that the evaluation includes a thorough review of the patient's 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 personality and behavioral disorders, enabling better tracking of conditions that arise from physiological causes. F07.9 provides a necessary option for cases where the specifics of the disorder are not fully defined but are linked to a known physiological condition.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of personality and behavioral disorders, enabling better tracking of conditions that arise from physiological causes. F07.9 provides a necessary option for cases where the specifics of the disorder are not fully defined but are linked to a known physiological condition.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of personality and behavioral disorders, enabling better tracking of conditions that arise from physiological causes. F07.9 provides a necessary option for cases where the specifics of the disorder are not fully defined but are linked to a known physiological condition.

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 types of physiological conditions can lead to F07.9?

Conditions such as traumatic brain injury, stroke, thyroid disorders, and metabolic imbalances can lead to personality and behavioral changes classified under F07.9.