F90.0 ICD-10 Code: Complete Guide to Attention-Deficit Hyperactivity Disorder, Predominantly Inattentive Type

Clinical Summary

The F90.0 code identifies the predominantly inattentive type of Attention-deficit hyperactivity disorder (ADHD) in the ICD-10-CM system. Our comprehensive breakdown of F90.0 covers key diagnostic markers, documentation essentials, and billing implications that impact healthcare providers daily. Mastering this code’s application directly affects billing accuracy, treatment strategies, and revenue cycles for mental health practices. 

Note: This content serves educational purposes only and shouldn’t replace official coding guidance. Providers must consult current medical coding guidelines and use clinical judgment when assigning diagnostic codes.

Introduction: 

Healthcare practice leaders and billing decision-makers face significant challenges in accurately documenting and coding mental health conditions. 

The F90.0 ICD-10 code designates Attention-deficit hyperactivity disorder, predominantly inattentive type; a neurodevelopmental disorder characterized by persistent patterns of inattention that interfere with functioning or development.

Proper application of the F90.0 code requires precise clinical documentation that satisfies both medical necessity requirements and payer-specific policies. 

This guide provides healthcare administrators, clinicians, and billing specialists with the essential information needed to navigate the complexities of ADHD diagnostic coding while optimizing reimbursement processes.

What is the F90.0 ICD-10 Code?

The F90.0 code is part of the ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) coding system under Chapter 5: Mental, Behavioral and Neurodevelopmental disorders (F01-F99). This specific code represents “Attention-deficit hyperactivity disorder, predominantly inattentive type,” previously known as ADD (Attention Deficit Disorder) in earlier classification systems.

F90.0 in the ICD-10 Hierarchy

Understanding the hierarchical position of F90.0 provides important context for its proper application:

Level	Code	Description
Chapter	F01-F99	Mental, Behavioral and Neurodevelopmental disorders
Category	F90	Attention-deficit hyperactivity disorders
Subcategory	F90.0	Attention-deficit hyperactivity disorder, predominantly inattentive type

The F90 category includes several related codes that clinicians must carefully differentiate:

Code	Description
F90.0	Attention-deficit hyperactivity disorder, predominantly inattentive type
F90.1	Attention-deficit hyperactivity disorder, predominantly hyperactive type
F90.2	Attention-deficit hyperactivity disorder, combined type
F90.8	Attention-deficit hyperactivity disorder, other type
F90.9	Attention-deficit hyperactivity disorder, unspecified type

Clinical Diagnostic Criteria for F90.0

The application of the F90.0 code requires thorough clinical assessment and documentation that aligns with established diagnostic criteria. According to current clinical guidelines, the predominantly inattentive presentation of ADHD is characterized by meeting six or more symptoms of inattention (five for older adolescents and adults) for at least six months, to a degree that is inconsistent with developmental level and negatively impacts social, academic, or occupational activities.

Inattention Symptoms Required for F90.0 Diagnosis

Accurate documentation must reference specific inattention symptoms, which may include:

Inattention Symptoms	Clinical Manifestations
Careless mistakes	Makes frequent errors in schoolwork, work, or activities requiring sustained attention
Sustaining attention	Difficulty maintaining focus during tasks, conversations, or prolonged reading
Listening	Appears not to listen when directly addressed
Following through	Fails to complete tasks, schoolwork, or workplace duties
Organization	Demonstrates poor organization skills in tasks and activities
Sustained mental effort	Avoids or is reluctant to engage in tasks requiring sustained mental effort
Losing items	Frequently misplaces materials necessary for tasks or activities
Distractibility	Easily distracted by extraneous stimuli or unrelated thoughts
Forgetfulness	Forgetful in daily activities, routine tasks, or appointments

For proper code assignment, clinicians must document that symptoms:

• Persist for at least 6 months
• Are inconsistent with developmental level
• Negatively impact functioning
• Were present before age 12
• Occur in two or more settings
• Are not better explained by another mental disorder

Documentation Requirements for Accurate F90.0 Coding

Healthcare providers must maintain comprehensive documentation to support the F90.0 diagnosis. This documentation is essential for both medical necessity validation and proper reimbursement.

Required Documentation Elements

Essential documentation components include:

Documentation Category	Required Elements
Symptom Assessment	Detailed description of inattention symptoms with severity and duration
Functional Impact	Specific effects on academic, social, or occupational functioning
Developmental History	Evidence of symptom onset before age 12
Multi-setting Confirmation	Documentation of symptoms across two or more settings (e.g., home, school, work)
Differential Diagnosis	Exclusion of other conditions that might better explain the symptoms
Standardized Assessments	Results from validated rating scales or neuropsychological testing
Treatment Planning	Outlined approaches for addressing the condition

Practices utilizing mental health CPT codes for ADHD assessment should ensure that documentation clearly supports both the diagnostic code and the procedural services provided. Common assessment procedures might include 90791 CPT code for psychiatric diagnostic evaluation or 96130 CPT code for psychological testing.

Billing and Reimbursement Considerations for F90.0

Understanding the reimbursement landscape for F90.0 is crucial for practice financial health. Several factors influence payment for services related to this diagnosis.

Payer Policies and Medical Necessity

Insurance coverage for ADHD assessment and treatment varies significantly across payers. Practice administrators should consider:

Payer Consideration	Key Points
Coverage Limitations	Many plans limit the number of assessment or therapy sessions
Prior Authorization	Requirements for specialized testing or certain treatments
Documentation Thresholds	Specific clinical findings needed to establish medical necessity
Allowed Provider Types	Restrictions on which providers can bill for ADHD services

Common Services Associated with F90.0

Services frequently billed with the F90.0 diagnosis include:

1. Initial Assessment Services: 90791 (psychiatric diagnostic evaluation) or 90792 (psychiatric diagnostic evaluation with medical services)
2. Psychological Testing: 96130/96131 (psychological testing administration and interpretation) and 96136/96137 (psychological test administration)
3. Therapy Services: 90832 (30-minute psychotherapy), 90834 (45-minute psychotherapy), or 90837 (60-minute psychotherapy)
4. Family Therapy: 90846 (family psychotherapy without patient) or 90847 (family psychotherapy with patient)
5. Group Therapy: 90849 (multiple-family group psychotherapy) or 90853 (group psychotherapy)
6. Telehealth Services: 98966, 98967, 98968, G2012, and G2010 for virtual check-ins and remote evaluations

Differential Diagnosis and Secondary Codes

Accurate diagnosis requires careful differentiation from other conditions with similar presentations. Clinicians should consider related mental health conditions that might better explain symptoms or occur comorbidly with ADHD.

Common Differential Diagnoses

Condition	ICD-10 Code	Distinguishing Features
Specific Learning Disorder	F81.0-F81.9	Difficulties specifically in academic skills acquisition
Intellectual Disability	F70-F79	Global cognitive impairment across multiple domains
Autism Spectrum Disorder	F84.0	Social communication deficits, restricted/repetitive behaviors
Major Depressive Disorder	F32.1, F32.2, F32.3	Episode-based attention problems with prominent mood symptoms
Generalized Anxiety Disorder	F41.1	Worry-driven concentration difficulties
Adjustment Disorder	F43.10	Stressor-related symptoms with clear temporal relationship
Bipolar Disorder	F31.9	Episodic attention problems during mood episodes
Obsessive-Compulsive Disorder	F42	Obsessions/compulsions causing attention difficulties

Comorbid Conditions

Many patients with ADHD present with coexisting conditions that require additional diagnostic codes. Common comorbidities include:

1. Oppositional Defiant Disorder (F91.3)
2. Conduct Disorder (F91.1-F91.9)
3. Anxiety Disorders (F41.1)
4. Mood Disorders (F30-F39)
5. Substance Use Disorders (F10-F19, including F10.20, F11.20, F12.20)
6. Learning Disorders (F81)

When comorbidities exist, proper sequencing of codes is essential for accurate claims processing. Generally, the condition that is the primary focus of treatment should be listed first.

Treatment Approaches for F90.0

Comprehensive management of predominantly inattentive ADHD typically involves multiple modalities. Documentation should clearly outline the treatment plan, which may include:

Evidence-Based Interventions

Treatment Modality	Typical Services	Associated Codes
Medication Management	Prescription and monitoring of stimulants, non-stimulants	E/M codes, 90792
Cognitive Behavioral Therapy	Individual therapy focused on organization, attention skills	90834, 90837
Parent Training	Family sessions to implement behavioral strategies	90846, 90847
Educational Interventions	School consultation, IEP/504 planning	Case management codes
Skills Training	Groups focusing on executive functioning skills	90853
Coaching	Individual support for the implementation of strategies	Case management codes

Providers should document the medical necessity for each treatment component and ensure that services align with evidence-based practice guidelines.

Practical Coding Tips for F90.0

Healthcare administrators and billing specialists should implement these strategies to optimize F90.0 coding:

1. Specificity Matters: Always use the most specific code available. F90.0 specifically indicates predominantly inattentive type, which differs from F90.1 (predominantly hyperactive type) or F90.2 (combined type).
2. Documentation Alignment: Ensure clinical notes clearly support the F90.0 diagnostic criteria with specific examples of inattentive symptoms.
3. Temporal Requirements: Confirm documentation indicates symptom duration of at least 6 months and onset before age 12.
4. Setting Verification: Document symptom presence across at least two settings (e.g., home and school).
5. Functional Impact: Clearly articulate how symptoms impair social, academic, or occupational functioning.
6. Annual Reassessment: Schedule regular reassessments to confirm continued applicability of the F90.0 code.
7. Comorbidity Documentation: When listing multiple diagnoses, ensure each is supported by distinct clinical evidence.

Revenue Cycle Optimization for F90.0 Services

Practices can implement strategic approaches to improve reimbursement for services related to the F90.0 diagnosis:

Best Practices for F90.0 Claims Management

1. Pre-authorization Protocols: Develop standardized processes for obtaining prior authorizations for ADHD assessments and treatments.
2. Clinician Education: Provide regular training on proper documentation requirements specific to F90.0.
3. Denial Prevention: Implement pre-submission claim reviews focusing on common F90.0 denial reasons.
4. Modifiers Usage: Appropriately apply modifiers when multiple services are delivered on the same date.
5. Documentation Templates: Develop structured templates that capture all required elements for F90.0 justification.

Practices seeking to optimize their mental health billing processes should consider specialized mental health billing services that understand the nuances of behavioral health coding and documentation requirements.

Related ICD-10 Mental Health Codes

Healthcare providers should be familiar with other commonly used mental health diagnostic codes that may be relevant in ADHD assessment and treatment:

Code	Description	Related to F90.0
F99	Mental disorder, not otherwise specified	Used temporarily pending definitive diagnosis
F32.9	Major depressive disorder, unspecified	Common comorbidity
F41.9	Anxiety disorder, unspecified	Common comorbidity
F91.9	Conduct disorder, unspecified	Common comorbidity
F81.9	Developmental disorder of scholastic skills, unspecified	Common comorbidity

For comprehensive reference on mental health coding, providers should review complete ICD-10 codes for mental health.

Conclusion: Ensuring Compliance and Optimizing Reimbursement

Accurate application of the F90.0 code requires a thorough understanding of both clinical diagnostic criteria and coding guidelines. Healthcare administrators and providers who implement best practices in documentation and coding can not only ensure compliance but also optimize reimbursement for ADHD assessment and treatment services.

Decision-makers in healthcare practices should consider implementing specialized billing solutions to address the complexities of mental health coding. MCB Collects offers comprehensive revenue cycle management services specifically designed for mental health practices, with expertise in navigating the intricate landscape of behavioral health reimbursement.

Taking Action to Improve F90.0 Coding and Billing

Practices struggling with denied claims or reduced reimbursements for ADHD services should consider:

1. Conducting a documentation audit to identify gaps in clinical support for F90.0 coding
2. Implementing specialized medical billing consulting services to address coding challenges
3. Exploring denial management services to recover missed revenue
4. Utilizing advanced medical billing reporting solutions to identify patterns in claim denials

With proper implementation of these strategies, healthcare practices can ensure appropriate reimbursement while delivering quality care to patients with predominantly inattentive ADHD.

Resources for Healthcare Providers

For additional guidance on mental health coding and billing, providers can access these authoritative resources:

1. American Psychiatric Association DSM-5 Coding Updates
2. American Academy of Pediatrics ADHD Clinical Practice Guidelines
3. Centers for Medicare & Medicaid Services Mental Health Services Billing Guide
4. American Academy of Professional Coders Behavioral Health Documentation Guidelines

Note: This content was medically reviewed by a board-certified psychiatrist specialized in ADHD diagnosis and treatment.