2025 ICD-10-CM code F84.9
Unspecified pervasive developmental disorder. This diagnosis is used when a child exhibits symptoms of pervasive developmental disorders but doesn't meet the specific criteria for conditions like autism or Asperger's syndrome.
Medical necessity is established by the presence of significant impairments in social interaction, communication, and restricted, repetitive behaviors that affect the child's daily functioning and development. Documentation should support the need for interventions and therapies related to the developmental delays and behavioral challenges.
Diagnosis is typically made by a healthcare professional specializing in developmental disorders, such as a developmental pediatrician, child psychiatrist, or psychologist.They will assess the child's developmental history, behavior, and social interactions. The Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria are often used as a guideline for diagnosis.
- V - Mental, Behavioral and Neurodevelopmental disorders
- F80-F89: Disorders of psychological development
In simple words: This diagnosis is used for children who have difficulties with social skills, communication, and show repetitive behaviors, but don't fit neatly into categories like autism or Asperger's.They might struggle with understanding language, connecting with others, and adapting to changes in routine.
A pervasive developmental disorder characterized by qualitative abnormalities in social interaction and communication, along with restricted, repetitive, and stereotyped patterns of behavior, interests, and activities. This diagnosis applies when the criteria for other specific pervasive developmental disorders (like autistic disorder, Rett's syndrome, childhood disintegrative disorder, or Asperger's syndrome) are not met. It is often referred to as atypical autism.
Example 1: A 3-year-old child presents with delayed language development, difficulty interacting with other children, and repetitive hand flapping.While they exhibit autistic traits, they do not fully meet the criteria for autistic disorder.F84.9 is used., A 5-year-old child demonstrates social awkwardness, rigid routines, and intense interests in specific topics, but their language development is normal.They do not meet the criteria for Asperger's syndrome. F84.9 may be applicable., A child exhibits significant developmental delays and unusual behaviors, but further assessment is needed to determine if they meet the criteria for a specific pervasive developmental disorder. In the interim, F84.9 may be used until a definitive diagnosis is reached.
Detailed developmental history, observations of the child's behavior and social interactions, assessments of communication skills, and any relevant medical or genetic evaluations should be documented. Information about the child's adaptive functioning and any associated intellectual disabilities should also be included.
** As of December 1st, 2024, the code F84.9 is still valid. However, coding practices and guidelines can change. It's always best practice to consult the most up-to-date ICD-10-CM coding manual and guidelines for current information and specific payer requirements.
- Payment Status: Active
- Specialties:Developmental Pediatrics, Child Psychiatry, Psychology, Pediatrics
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Community Mental Health Center, Federally Qualified Health Center