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2025 ICD-10-CM code F45

Somatoform disorders are mental health conditions where individuals experience physical symptoms without a clear medical explanation.

Coding should be consistent with the DSM-5 criteria and current ICD-10-CM guidelines.Appropriate documentation is crucial for accurate coding and reimbursement.

Modifiers may be used in certain circumstances (e.g. multiple diagnoses, different providers involved in care), but specific modifier usage depends on the circumstances.

Medical necessity is established by the presence of clinically significant symptoms that significantly impair the patient's daily life and functioning.These symptoms must not be attributable to other medical conditions or substances and require psychological interventions to improve the patient's overall health and well-being.

The clinical responsibility involves a comprehensive evaluation of the patient's history, physical examination, and the exclusion of other medical or mental health conditions.Treatment may involve individual and/or family therapy, and possibly referral to other specialists as needed.The provider's role is to diagnose, manage, and treat the patient's symptoms and overall psychological well-being.

IMPORTANT Excludes: dissociative and conversion disorders (F44.-), factitious disorders (F68.1-, F68.A),malingering (conscious simulation) (Z76.5), psychological or behavioral factors associated with disorders or diseases classified elsewhere (F54), and other specified somatoform disorders.

In simple words: Somatoform disorders are mental health problems where people have physical symptoms like pain or stomach issues, but doctors can't find a physical cause.These symptoms aren't fake; they're real to the person experiencing them. Treatment often involves talking to a therapist to help cope with the symptoms and improve overall well-being.

Somatoform disorders encompass a range of mental health conditions characterized by physical symptoms that cannot be fully explained by a general medical condition, another mental disorder, or the direct effects of a substance.These symptoms are not intentionally produced or feigned.The symptoms may be relatively mild (e.g., anxiety, headaches, stomach aches) or more severe (e.g., widespread pain, sexual dysfunction, neurological symptoms).Diagnosis involves a comprehensive evaluation of the patient's history, physical examination, and consideration of other potential diagnoses, often employing tools such as the DSM-5 criteria and various symptom rating scales. Treatment typically focuses on improving overall functioning rather than solely managing symptoms and may include therapies like psychological counseling and cognitive behavioral therapy (CBT).Family and friend support may also prove beneficial.

Example 1: A 35-year-old female presents with chronic fatigue, widespread pain, and gastrointestinal issues for the past two years.Extensive medical workup reveals no physical cause. She is diagnosed with somatoform disorder and undergoes CBT., A 28-year-old male experiences recurrent episodes of paralysis in his left arm with no neurological basis. Multiple tests, including MRI, are negative.He is diagnosed with conversion disorder, a type of somatoform disorder, and is referred for psychotherapy., A 40-year-old female exhibits persistent anxiety and multiple physical complaints (headaches, palpitations, dizziness) that are inconsistent with findings from various physical examinations.After thorough evaluation, she is diagnosed with somatization disorder and starts counseling.

Detailed patient history, including duration and character of symptoms; results of relevant physical examinations and laboratory tests; documentation of psychological evaluation, including standardized diagnostic tools like DSM-5 criteria and symptom rating scales; treatment plans including psychotherapy approaches and follow-up care plans.

** Careful clinical judgment is essential for proper diagnosis and coding to ensure that other conditions are ruled out before assigning this diagnosis.The ICD-10-CM guidelines should always be consulted for the most up-to-date information.

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