ICD Coding Guide

Insurance billing and its associated terminology can be confusing and difficult to navigate as a therapist. Because of this, it can be very easy to choose the wrong code which can result in claims denial, costly mistakes, and increased paperwork. 

Carpenters like to say “measure twice cut once”. In our world, being careful and double checking your coding is always worth the extra effort. 

Let’s break down and listing the commonly used ICD codes that are used in behavioral health from the *DSM-5-TR.

NOTE  *If you do not have a copy of the DSM-5-TR you can order it through Amazon or through the APA Publishing Company

ICD codes 

F01-F09 Mental disorders due to known physiological conditions

• F01  Vascular dementia
• F02  Dementia in other diseases classified elsewhere
• F03  Unspecified dementia
• F04  Amnestic disorder due to known physiological condition
• F05  Delirium due to known physiological condition
• F06  Other mental disorders due to known physiological condition
• F07  Personality and behavioral disorders due to known physiological condition
• F09  Unspecified mental disorder due to known physiological condition

F10-F19  Mental and behavioral disorders due to psychoactive substance use

• F10  Alcohol related disorders
• F11  Opioid related disorders
• F12  Cannabis related disorders
• F13  Sedative, hypnotic, or anxiolytic related disorders
• F14  Cocaine related disorders
• F15  Other stimulant related disorders
• F16  Hallucinogen related disorders
• F17  Nicotine dependence
• F18  Inhalant related disorders
• F19  Other psychoactive substance related disorders

F20-F29 Schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders

• F20  Schizophrenia
• F21  Schizotypal disorder
• F22  Delusional disorders
• F23  Brief psychotic disorder
• F24  Shared psychotic disorder
• F25  Schizoaffective disorders
• F28  Other psychotic disorder not due to a substance or known physiological condition
• F29  Unspecified psychosis not due to a substance or known physiological condition

F30-F39 Mood [affective] disorders 

• F30  Manic episode
• F31  Bipolar disorder
• F32  Major depressive disorder, single episode
• F33  Major depressive disorder, recurrent
• F34  Persistent mood [affective] disorders
• F39  Unspecified mood [affective] disorder

F40-F48 Anxiety, dissociative, stress-related, somatoform & other nonpsychotic mental disorders  

• F40  Phobic anxiety disorders
• F41  Other anxiety disorders
• F42  Obsessive-compulsive disorder
• F43  Reaction to severe stress, and adjustment disorders
• F43.8 Prolonged grief disorder
• F44  Dissociative and conversion disorders
• F45  Somatoform disorders
• F48  Other nonpsychotic mental disorders

F50-F59 Behavioral syndromes associated with physiological disturbances and physical factors 

• F50  Eating disorders
• F51  Sleep disorders not due to a substance or known physiological condition
• F52  Sexual dysfunction not due to a substance or known physiological condition
• F53  Mental and behavioral disorders associated with the puerperium, not elsewhere classified
• F54  Psychological and behavioral factors associated with disorders or diseases classified elsewhere
• F55  Abuse of non-psychoactive substances
• F59  Unspecified behavioral syndromes associated with physiological disturbances and physical factors

F80-F89 Pervasive and specific developmental disorders › Pervasive and specific developmental disorders 

• F80  Specific developmental disorders of speech and language
• F81  Specific developmental disorders of scholastic skills
• F82  Specific developmental disorder of motor function
• F84  Pervasive developmental disorders
• F88  Other disorders of psychological development
• F89  Unspecified disorder of psychological development

F90-F98 Behavioral and emotional disorders with onset usually occurring in childhood and adolescence

• F90  Attention-deficit hyperactivity disorders
• F91  Conduct disorders
• F93  Emotional disorders with onset specific to childhood
• F94  Disorders of social functioning with onset specific to childhood and adolescence
• F95  Tic disorder
• F98  Other behavioral and emotional disorders with onset usually occurring in childhood and adolescence
• F99 Unspecified mental disorder  

Z Codes

**Insurance will often deny a claim if an F code is not associated in addition to a Z code. Be mindful of this when submitting claims in your portal as a Z-code-only claim could result in zero coverage for a client’s session. 

• Z00-Z99  Factors influencing health status and contact with health services
• Z00-Z13  Persons encountering health services for examinations
• Z14-Z15  Genetic carrier and genetic susceptibility to disease
• Z16-Z16  Resistance to antimicrobial drugs
• Z17-Z17  Estrogen receptor status
• Z18-Z18  Retained foreign body fragments
• Z19-Z19  Hormone sensitivity malignancy status
• Z20-Z29  Persons with potential health hazards related to communicable diseases
• Z30-Z39  Persons encountering health services in circumstances related to reproduction
• Z40-Z53  Encounters for other specific health care
• Z55-Z65  Persons with potential health hazards related to socioeconomic and psychosocial circumstances
• Z66-Z66  Do not resuscitate status
• Z67-Z67  Blood type
• Z68-Z68  Body mass index (BMI)
• Z69-Z76  Persons encountering health services in other circumstances
• Z77-Z99  Persons with potential health hazards related to family and personal history and certain conditions influencing health status

T, R and Z codes for suicidal behavior and nonsuicidal self-injury

Current suicidal behavior

• T14.91A Initial encounter
• T14.91D Subsequent encounter
• Z91.51 History of suicidal behavior

Nonsuicidal self-injury

• R45.88 Current nonsuicidal self-injury
• Z91.52 History of nonsuicidal self-injury