2025 ICD-10-CM code F43.21
(Active) Effective Date: N/A Revision Date: N/A Mental, Behavioral, and Neurodevelopmental disorders - Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders Chapter V: Mental and behavioural disorders Feed
Adjustment disorder with depressed mood, characterized by persistent sadness and hopelessness following a stressful life event.
Medical necessity is established by demonstrating a direct causal link between a significant stressor and the development of clinically significant depressive symptoms that impair social, occupational, or other important areas of functioning.The severity and duration of symptoms should warrant professional intervention.
The clinical responsibility involves a comprehensive assessment of the patient's symptoms, history of stressors, and overall mental health.This includes a thorough mental status examination, evaluation of the severity and impact of depressive symptoms, and consideration of other potential contributing factors.Treatment planning may involve psychotherapy, medication management (antidepressants), or a combination of both.
In simple words: This code describes a mental health problem that happens when someone has trouble coping with a difficult event, like a death or job loss. They feel very sad, hopeless, and worthless for longer than usual after the event.It's different from normal grief and is usually treated with therapy and sometimes medication.
F43.21, Adjustment disorder with depressed mood, is an ICD-10-CM code representing a mental disorder stemming from an identifiable stressor within three months of the event onset.Clinical presentation includes prominent symptoms of depression like sadness, hopelessness, low self-esteem, and feelings of worthlessness, disproportionate to the stressor's intensity.The disorder doesn't meet criteria for other mental illnesses and isn't merely an exacerbation of a pre-existing condition or normal bereavement. Symptoms typically resolve within six months of the stressor ceasing.
Example 1: A 35-year-old woman experiences persistent sadness and low self-esteem after losing her job. Her symptoms significantly impair her social functioning and ability to find new employment, meeting the criteria for F43.21., A 20-year-old college student develops feelings of hopelessness and helplessness following a family member's death.Their academic performance declines, and they withdraw socially, prompting a diagnosis of F43.21., A 60-year-old man struggles with persistent sadness and loss of interest after retiring, although initially looking forward to retirement. He has difficulty engaging in previously enjoyed activities, fitting the criteria for F43.21.
Detailed documentation is crucial, including a thorough history of the stressful event, onset and duration of symptoms, severity of depressive symptoms (using validated scales if possible), impact on daily functioning, and the ruling out of other mental disorders.Treatment plan and progress notes are also vital for proper coding.
** The severity of the depression should be documented to justify the medical necessity of treatment.Consider using standardized assessment tools to gauge symptom severity.
- Payment Status: Active
- Specialties:Psychiatry, Psychology, Primary Care
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Telehealth