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ICD-10 Guide
ICD-10 CodesF43.21

F43.21

Billable

Adjustment disorder with depressed mood

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

Code Description

ICD-10 F43.21 is a billable code used to indicate a diagnosis of adjustment disorder with depressed mood.

Key Diagnostic Point:

Adjustment disorder with depressed mood is a psychological condition that arises in response to a significant life stressor or change, leading to emotional and behavioral symptoms that are disproportionate to the severity of the stressor. This disorder is characterized by feelings of sadness, hopelessness, and a lack of interest or pleasure in daily activities. Patients may also experience anxiety, difficulty concentrating, and changes in sleep or appetite. The symptoms typically develop within three months of the identifiable stressor and can last for up to six months after the stressor has ended. It is important to differentiate this condition from other mood disorders, as the symptoms are directly linked to the stressor and are not due to a pre-existing mood disorder. Treatment often involves psychotherapy, such as cognitive-behavioral therapy, and may include medication for managing symptoms of depression. Understanding the context of the stressor is crucial for effective treatment and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating from other mood disorders and anxiety disorders
  • Identifying the specific stressor and its impact on the patient
  • Documenting the duration and severity of symptoms
  • Understanding the interplay between adjustment disorders and other mental health conditions

Audit Risk Factors

  • Inadequate documentation of the stressor
  • Failure to specify the duration of symptoms
  • Misclassification of the disorder as a primary mood disorder
  • Lack of evidence for treatment interventions

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed patient history, including stressor identification and symptom duration.

Common Clinical Scenarios

Patients presenting with depressive symptoms following a divorce, job loss, or other significant life changes.

Billing Considerations

Ensure that the stressor is clearly documented and linked to the patient's symptoms.

Primary Care

Documentation Requirements

Comprehensive assessment of mental health status and any physical health concerns.

Common Clinical Scenarios

Patients with somatic complaints that may be linked to adjustment disorder.

Billing Considerations

Consider referral to mental health specialists for further evaluation and treatment.

Coding Guidelines

Inclusion Criteria

Use F43.21 When
  • According to the ICD
  • 10 coding guidelines, F43
  • 21 should be used when the symptoms are directly related to a specific stressor and are not better explained by another mental health condition
  • The symptoms must occur within three months of the stressor and last no longer than six months after the stressor has ended

Exclusion Criteria

Do NOT use F43.21 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

90834CPT Code

Psychotherapy, 45 minutes with patient.

Clinical Scenario

Used for patients receiving therapy for adjustment disorder.

Documentation Requirements

Document the duration of the session and the focus of therapy.

Specialty Considerations

Psychiatrists and psychologists should ensure that the treatment plan aligns with the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of adjustment disorders, improving the ability to capture the nuances of these conditions and their treatment needs.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of adjustment disorders, improving the ability to capture the nuances of these conditions and their treatment needs.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of adjustment disorders, improving the ability to capture the nuances of these conditions and their treatment needs.

Resources

Clinical References

  • •
    American Psychiatric Association - Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

Coding & Billing References

  • •
    American Psychiatric Association - Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

Frequently Asked Questions

What is the difference between adjustment disorder and major depressive disorder?

Adjustment disorder is specifically triggered by a stressor and is time-limited, while major depressive disorder can occur without an identifiable stressor and may last longer.