2025 ICD-10-CM code F63.0
(Valid) Effective Date: N/A Mental, Behavioral and Neurodevelopmental disorders - F63 6 Feed
Pathological gambling.
Medical necessity for treatment of pathological gambling is established by the presence of a diagnosable gambling disorder that significantly impairs the individual's functioning and requires professional intervention.The documentation should demonstrate the severity of the disorder and the need for treatment to address the associated symptoms and consequences.
Diagnosis of pathological gambling involves assessing the patient's gambling history, identifying patterns of behavior consistent with the diagnostic criteria (e.g., DSM-5), evaluating the impact of gambling on the patient's life, and ruling out other mental health conditions. Treatment typically includes psychotherapy (e.g., cognitive behavioral therapy), support groups (e.g., Gamblers Anonymous), and in some cases, medication. The information provided in this response is for general educational purposes only and should not be considered as medical advice. Please consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
In simple words: Pathological gambling is when someone can't stop gambling even when it causes serious problems in their life, like losing money, relationships, or their job. They feel a strong urge to gamble and often bet more and more money to get the same thrill.They may lie about their gambling or resort to stealing to support it.
Pathological gambling, also known as compulsive gambling or gambling disorder, is characterized by persistent and recurrent maladaptive gambling behavior that disrupts personal, family, or vocational pursuits.The individual has difficulty controlling gambling impulses, often gambles with increasing amounts of money, becomes preoccupied with gambling, may lie or steal to fund gambling, and may jeopardize relationships or employment due to gambling.
Example 1: A 45-year-old male presents with mounting debt, strained family relationships, and job loss due to his inability to stop gambling. He admits to frequently chasing losses, lying about his gambling, and feeling irritable when attempting to cut back., A 28-year-old female seeks help for her gambling habit, which has escalated in recent years. She experiences intense anxiety when not gambling and has resorted to stealing to fund her habit.She expresses feelings of guilt and shame about her behavior., A 60-year-old individual acknowledges a lifelong gambling problem, which has led to multiple financial crises and strained relationships. They describe a pattern of increasing bets and an inability to stop gambling despite repeated attempts.
Documentation should include details of the patient's gambling behavior, including frequency, duration, amounts wagered, types of gambling involved, consequences experienced (e.g., financial, relational, occupational), and any associated psychological symptoms.Evidence of impaired control over gambling, such as chasing losses, lying about gambling, and unsuccessful attempts to quit, should be documented.
- Specialties:Psychiatry, Psychology, Addiction Medicine
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office, Community Mental Health Center, Residential Substance Abuse Treatment Facility