ICD-10 Code for Starting Vyvanse in a Teenager with ADHD
Use the specific ICD-10 code that corresponds to the teenager's ADHD presentation type: F90.2 for combined presentation, F90.0 for predominantly inattentive presentation, or F90.1 for predominantly hyperactive-impulsive presentation. 1
ADHD Presentation-Specific ICD-10 Codes
The DSM-5 criteria define four dimensions of ADHD with corresponding ICD-10 codes that you must select based on the teenager's symptom pattern 1:
F90.2 (314.01): ADHD, combined presentation - Use when the patient meets criteria for both inattention AND hyperactivity-impulsivity domains 1
F90.0 (314.00): ADHD, predominantly inattentive presentation - Use when inattention criteria are met but hyperactivity-impulsivity criteria are not fully met 1
F90.1 (314.01): ADHD, predominantly hyperactive-impulsive presentation - Use when hyperactivity-impulsivity criteria are met but inattention criteria are not fully met 1
F90.8 (314.01): ADHD, other specified and unspecified - Use for atypical presentations 1
Clinical Context for Prescribing Vyvanse
For adolescents (age 12-18 years) with ADHD, FDA-approved medications including Vyvanse should be prescribed with the adolescent's assent. 1 The American Academy of Pediatrics provides Grade A (strong recommendation) evidence supporting stimulant medication use in this age group 1.
Key Documentation Requirements
Before prescribing, you must document 1, 2:
- Childhood symptom onset before age 12 - This is mandated by DSM-5 criteria and helps distinguish genuine ADHD from malingering 2
- Impairment in multiple settings - Obtain reports from parents/guardians about childhood symptoms, academic records, and current school functioning 2
- Collateral information consistency - Verify that self-report aligns with information from other sources to rule out malingering 2
Vyvanse-Specific Considerations
Lisdexamfetamine (Vyvanse) is a prodrug that converts to d-amphetamine after oral administration, providing once-daily dosing with reduced abuse potential 3, 4. Starting dosage is typically 20-30 mg once daily in the morning, with weekly titration by 10 mg increments up to a maximum of 70 mg daily 1.
Common pitfall: Do not use unspecified ADHD codes (F90.8/F90.9) when a specific presentation type can be determined, as this reduces diagnostic precision and may affect insurance authorization 1.