ICD-10 Codes for ADHD Assessment
The primary ICD-10 codes for ADHD assessment depend on the specific presentation identified during evaluation: F90.0 for predominantly inattentive presentation, F90.1 for predominantly hyperactive-impulsive presentation, F90.2 for combined presentation, and F90.8 for other specified/unspecified ADHD. 1
Specific ICD-10 Code Assignments
The DSM-5 diagnostic framework, which guides ICD-10 coding, recognizes four distinct ADHD presentations with corresponding codes 1:
F90.0 (314.00): ADHD, predominantly inattentive presentation - used when 6 or more inattention symptoms are rated "often/very often" AND fewer than 6 hyperactivity-impulsivity symptoms are present 2
F90.1 (314.01): ADHD, predominantly hyperactive-impulsive presentation - used when 6 or more hyperactivity-impulsivity symptoms are rated "often/very often" AND fewer than 6 inattention symptoms are present 1, 2
F90.2 (314.01): ADHD, combined presentation - used when 6 or more symptoms in BOTH inattention AND hyperactivity-impulsivity domains are present 1, 2
F90.8 (314.01): ADHD, other specified and unspecified - used for presentations that don't meet full criteria for the above categories 1
Critical Coding Considerations
The correct ICD-10 code cannot be assigned until a comprehensive diagnostic evaluation is completed, as the code reflects the specific presentation pattern identified through systematic assessment. 3, 2
Required Elements Before Code Assignment
Verification that DSM-5 criteria are met with symptoms causing impairment in more than one setting (home, school, work) based on information from multiple sources including parents, teachers, and other observers 3
Documentation that symptoms have been present before age 12 years and persist for at least 6 months 3
Confirmation of functional impairment in more than one major setting (social, academic, or occupational) 3, 2
Ruling out alternative causes for symptoms through clinical interview and examination 3, 2
Assessment Tools That Inform Coding
Use DSM-based ADHD rating scales (such as Vanderbilt ADHD Rating Scales for ages 6-12 years) from both parents and teachers to systematically document symptom patterns across settings 3, 2
The Conners Rating Scale provides age-specific versions that help differentiate between the different ADHD presentations (inattentive, hyperactive-impulsive, and combined) 3
For adults, the Conners Adult ADHD Rating Scale (CAARS) or Adult ADHD Self-Report Scale can guide appropriate code selection 3, 4
Common Pitfalls to Avoid
Never assign an ICD-10 code based solely on rating scale scores without comprehensive clinical evaluation - rating scales serve to systematically collect symptom information but do not diagnose ADHD by themselves 3
Avoid using outdated terminology - the term "ADD" is outdated and should not be used; instead use "ADHD, predominantly inattentive presentation" (F90.0) for patients presenting primarily with inattention 1
Do not code before screening for comorbid conditions - anxiety, depression, oppositional defiant disorder, learning disabilities, and sleep disorders may alter the clinical picture and must be systematically assessed before finalizing the diagnosis and code 3, 2
Failing to gather information from multiple sources and settings leads to inaccurate presentation classification and incorrect code assignment 3, 2
Age-Specific Coding Nuances
For preschool-aged children (4-5 years), parent training in behavior management may be recommended before assigning a definitive ADHD diagnosis and code 3, 2
Girls with ADHD are more likely to present with predominantly inattentive symptoms (F90.0) rather than hyperactive symptoms, which can lead to underdiagnosis if not specifically assessed 2
Only 5.5-6.8% of children with ADHD continue to meet full diagnostic criteria (and thus maintain the same ICD-10 code) into young adulthood, though functional impairment may persist 5