ICD-10 Codes for ADHD Assessment
The 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 ADHD. 1
Specific ICD-10 Coding Structure
The DSM-5 diagnostic framework, which aligns with ICD-10 coding, requires using "Attention-Deficit/Hyperactivity Disorder" as the umbrella diagnosis followed by the specific presentation type 1:
F90.0 (314.00): ADHD, predominantly inattentive presentation - requires 6 or more inattention symptoms rated "often/very often" AND fewer than 6 hyperactivity-impulsivity symptoms 1, 2
F90.1 (314.01): ADHD, predominantly hyperactive-impulsive presentation - requires 6 or more hyperactivity-impulsivity symptoms rated "often/very often" AND fewer than 6 inattention symptoms 1, 2
F90.2 (314.01): ADHD, combined presentation - requires 6 or more symptoms in BOTH inattention AND hyperactivity-impulsivity domains 1, 2
F90.8 (314.01): ADHD, other specified and unspecified 1
Critical Coding Considerations
The correct ICD-10 code cannot be assigned until a complete diagnostic evaluation is performed, which requires 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, 2.
Required Documentation Before Coding
- Symptoms must have been present before age 12 years and persist for at least 6 months 3
- Functional impairment must be documented in more than one major setting (social, academic, or occupational) 3, 2
- Alternative causes for symptoms must be ruled out 3
- At least 6 symptoms in the relevant domain(s) rated as occurring "often" or "very often" on standardized rating scales 2
Practical Implementation
Use DSM-5-based ADHD rating scales (such as Vanderbilt scales) from both parents and teachers to systematically collect symptom information across settings, which is essential for accurate coding 3, 2. The rating scales serve to document which specific presentation criteria are met, directly determining the appropriate ICD-10 code 3.
Common Coding Pitfalls to Avoid
- Never use the outdated term "ADD" or code it separately - this terminology is no longer clinically appropriate and should be replaced with "ADHD, predominantly inattentive presentation" (F90.0) 1
- Do not assign an ICD-10 code based solely on questionnaire scores without clinical interview, multi-informant data, and documentation of functional impairment in multiple settings 3
- Girls with ADHD are more likely to meet criteria for F90.0 (predominantly inattentive) rather than hyperactive presentations, which can lead to underdiagnosis if hyperactivity is expected 2
Relationship to ICD-10 Hyperkinetic Disorder
The ICD-10 also includes a separate diagnostic entity called "Hyperkinetic Disorder" (F90.0 in ICD-10 clinical criteria), which has more stringent requirements than DSM-IV/DSM-5 ADHD and identifies a more severe subset of cases 4, 5. However, current American Academy of Pediatrics guidelines recommend using the DSM-5 criteria and corresponding ICD-10 codes (F90.0, F90.1, F90.2, F90.8) rather than the stricter ICD-10 Hyperkinetic Disorder criteria 1, 3.