ICD-10 Codes F43.10, F43.11 & F43.12

Post-traumatic stress disorder (PTSD) is a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event, such as a natural disaster, a serious accident, a terrorist act, war/combat, or rape, or who have been threatened with death, sexual violence, or serious injury.

Diagnosis requires exposure to a traumatic event, followed by persistent re-experiencing of the event, avoidance of stimuli associated with the trauma, negative alterations in cognitions and mood, and marked alterations in arousal and reactivity. Symptoms must last for more than one month. The unspecified code F43.10 is utilized when the medical record documentation does not provide sufficient detail to categorize the condition as acute or chronic.

Suggested ICD-10 Codes

• F43.10 – Post-traumatic stress disorder, unspecified | Billable
• F43.11– Post-traumatic stress disorder, acute | Billable
• F43.12– Post-traumatic stress disorder, chronic | Billable

F43.10 Post-traumatic stress disorder, unspecified | Billable

F43.10: Post-traumatic stress disorder, unspecified. A psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, or rape or who have been threatened with death, sexual violence or serious injury.

Detailed Description for F43.10

Post-traumatic stress disorder (PTSD) is a trauma- and stressor-related disorder. Clinical manifestations include intrusive symptoms such as flashbacks and nightmares, avoidance of stimuli associated with the trauma, negative alterations in cognition and mood, and marked alterations in arousal and reactivity, including hypervigilance and exaggerated startle response.

For a diagnosis of PTSD, symptoms must persist for more than one month and cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The unspecified designation F43.10 is utilized when the clinical documentation confirms the diagnosis of PTSD but does not provide further detail regarding the duration or specific subtype, such as acute versus chronic.

Includes

Post-traumatic stress disorder NOS

Acute stress reaction (F43.0); Adjustment disorders (F43.2)

Excludes

• Acute stress reaction (F43.0); Adjustment disorders (F43.2)
• Anxiety disorders (F41.-); Obsessive-compulsive disorder (F42.-)

F43.11 Post-traumatic stress disorder, acute, unspecified | Billable

Post-traumatic stress disorder (PTSD), acute, is a psychiatric disorder that may occur in individuals who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, or sexual violence. The acute designation applies when the duration of symptoms is at least 1 month but less than 3 months following the traumatic event.

Detailed Description for F43.11

Clinical manifestations include intrusive symptoms such as distressing memories, flashbacks, and nightmares; avoidance of stimuli associated with the trauma; negative alterations in cognitions and mood; and marked alterations in arousal and reactivity, including hypervigilance and an exaggerated startle response. Diagnosis requires that the symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. If symptoms persist for three months or longer, the condition is classified as chronic PTSD.

Includes

Acute post-traumatic stress disorder

Excludes

• Acute stress reaction (F43.0)
• Post-traumatic stress disorder, chronic (F43.12); Post-traumatic stress disorder, unspecified (F43.10)

F43.12: Post-traumatic stress disorder, chronic | Billable

Detailed Description for F43.12

Post-traumatic stress disorder (PTSD), chronic, is a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, or rape or who have been threatened with death, sexual violence or serious injury.

For a diagnosis of chronic PTSD under ICD-10-CM, the duration of symptoms must exceed three months. Clinical manifestations typically include four clusters: intrusion (e.g., flashbacks, distressing dreams), avoidance of stimuli associated with the trauma, negative alterations in cognitions and mood (e.g., inability to remember aspects of the trauma, persistent negative emotional state), and alterations in arousal and reactivity (e.g., hypervigilance, exaggerated startle response). Documentation should specify the chronicity to distinguish from acute PTSD (F43.11).

Includes

Chronic post-traumatic stress disorder

Excludes

• Acute stress reaction (F43.0); Adjustment disorders (F43.2)
• Post-traumatic stress disorder, acute (F43.11); Post-traumatic stress disorder, unspecified (F43.10)