ICD-10 code for unspecified OCD
Living with an obsessive-compulsive disorder can feel like being trapped in a torturous cycle of your own thoughts and/or behaviors. The support of a therapist can be transformational — but, that starts with the right diagnosis.
The ICD-10 code for unspecified obsessive-compulsive disorder is F42.9. This code is distinct from diagnoses like obsessive-compulsive disorder (F42.0) and mixed OCD (F42.2), and captures cases where those diagnoses might not yet be possible.
Though F42.9 is used for more ambiguous cases of OCD, there’s no questioning how widespread these conditions are, with 1 in 40 adults developing some form of OCD over the course of their life.
When to use F42.9 for OCD
Up until 2016, the code F42 could be used somewhat generally applied for most OCD-related diagnoses. Since then, diagnosis and coding has been updated to be much more specific. Using the most accurate code for each client is crucial to maintain compliance, avoid audits, and reduce claim denials.
F42.9 vs. F42.0
F42.0 serves as an umbrella code of sorts for obsessive-compulsive disorder. When the diagnostic criteria for OCD has been met, but you are still gaining an understanding of the mix of obsessional thoughts and compulsive acts, F42.0 is appropriate to use. By contrast, F42.9 captures “unspecified” cases of OCD, where further assessment might be required to understand how the client’s presentation relates to the DSM’s diagnostic criteria.
Unspecified OCD vs. “other” obsessive-compulsive disorders
While F42.9 is used for unspecified cases of OCD, F42.8 is used to capture other obsessive-compulsive disorders. This could include a number of differential diagnoses from the more typical presentations of OCD. F42.8 should be used where you have a reasonably complete understanding of the symptoms being presented, and recognize it as being outside more typical OCD diagnoses (such as mixed obsessional thoughts and acts).
ICD-10 codes for other OCD-related diagnoses
- F42.2 Mixed OCD
- F42.3 Hoarding disorder
- F42.4 Excoriation (skin picking) disorder
- F60.5 Obsessive-compulsive personality disorder
Interventions and CPT codes for unspecified OCD
1-3 short sentences on ways behavioral health care providers might use the featured diagnosis to guide treatment.
Individual psychotherapy
Exposure and response prevention (ERP) has emerged as the gold standard of treatment for obsessive-compulsive disorders, joining cognitive behavioral therapy (CBT) as the most common approach for psychotherapy. When billing for individual psychotherapy, you’ll need to use the right CPT code for the duration of the session.
- 90832: 30-minute sessions
- 90834: 45-minute sessions
- 90837: 60-minute sessions
Evaluation and management services
When your patient’s diagnosis is unspecified, you are far more likely to be delivering evaluation and management (E/M) services within the same sessions that you provide psychotherapy. The following add-on codes should only be used when both psychotherapy and E/M services are being provided.
- 90833: 30 minutes of psychotherapy performed with E/M service
- 90836: 45 minutes of psychotherapy performed with E/M service
- 90838: 60 minutes of psychotherapy performed with E/M service
Supporting clients with unspecified OCD
The journey to diagnosis is rarely linear. It may, at times, follow the well-traveled paths of typical diagnoses. And other times, it may go off-road to forge a more nuanced understanding of your client’s presentation.
In all cases, this adventure should culminate in a diagnosis that follows the unique, beautiful, and wild contours of your client’s lived experience.
Upheal equips the best clinicians to deliver more nuanced care — even in the face of complex and ambiguous presentations — by making it easier than ever to create the more clinically-accurate progress notes.
