2025 ICD-10-CM code F84.0
(Active) Effective Date: N/A Revision Date: N/A Neurodevelopmental disorders - Pervasive and specific developmental disorders Chapter V: Mental, Behavioral and Neurodevelopmental disorders (F01-F99) Feed
Autistic disorder, a neurodevelopmental disorder characterized by impaired social interaction, communication difficulties, and restricted/repetitive behaviors.
Modifiers may be applicable depending on the specific services provided and the circumstances of the encounter.Consult official coding guidelines for appropriate modifier use.
Medical necessity for services related to autistic disorder (F84.0) is established based on the severity of symptoms, functional impairment, and the potential for interventions to improve the individual's quality of life and reduce the impact of the disorder.Payers typically require documentation demonstrating the need for specific therapies and support services based on individual needs.
Diagnosis and treatment of autistic disorder often involve a multidisciplinary team, including pediatricians, neurologists, psychologists, developmental specialists, occupational therapists, speech-language pathologists, and behavioral therapists.The clinical responsibility depends on the individual's needs and the specific area of concern (e.g., behavioral interventions, speech therapy).
- Chapter V: Mental, Behavioral and Neurodevelopmental disorders (F01-F99)
- F84.0 falls under the broader category of pervasive developmental disorders (F80-F89) within Chapter V of the ICD-10-CM.
In simple words: Autistic disorder is a condition affecting how a person interacts socially, communicates, and behaves. It usually shows up before age three and involves trouble with social skills, communication, and repetitive behaviors.There is no cure, but various therapies can help individuals manage symptoms and improve their daily lives.
F84.0, Autistic disorder, is an ICD-10-CM code representing a neurodevelopmental disorder typically diagnosed in early childhood.It is characterized by persistent deficits in social communication and interaction across multiple contexts, as well as restricted, repetitive patterns of behavior, interests, or activities.The diagnosis involves a comprehensive assessment considering developmental history, behavioral observations, and standardized assessments, ruling out other potential causes.Treatment is multidisciplinary, often including behavioral therapies (like Applied Behavior Analysis), occupational therapy, speech therapy, and sometimes medication for associated behavioral challenges.
Example 1: A 2-year-old child presents with significant delays in language development, limited eye contact, and repetitive hand flapping. After a comprehensive evaluation, the diagnosis of autistic disorder (F84.0) is made, and the child begins early intervention services, including ABA therapy and speech therapy., A 10-year-old child with a diagnosis of autistic disorder (F84.0) struggles with social skills in school. They are referred to an occupational therapist for social skills training and to a psychologist for cognitive behavioral therapy to address anxiety associated with social situations., An adult diagnosed with autistic disorder (F84.0) experiences challenges with executive functioning and daily living skills. They work with an occupational therapist to improve daily living skills and develop coping strategies for managing sensory sensitivities and anxiety.
Comprehensive documentation is required to support the diagnosis of F84.0. This should include a detailed history of developmental milestones, observations of social interaction and communication skills, assessment of repetitive behaviors, results of standardized diagnostic tests, and any relevant medical or psychological evaluations.Documentation should also detail the treatment plan and progress notes throughout the course of care.
** The severity of autistic disorder can vary widely. The diagnosis should not be made solely based on the presence of a few behaviors; a thorough evaluation that considers various developmental areas is required for a definitive diagnosis. Early diagnosis and intervention are crucial for optimizing outcomes.
- Payment Status: Active
- Specialties:Pediatrics, Psychiatry, Neurology, Developmental-Behavioral Pediatrics, Clinical Psychology
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Other Place of Service (depending on the setting of care)