Chapter V - Mental and behavioural disorders

Question 1

What do the 4th character subdivisions for use with categories F10-F19 describe?

Answer 1

The clinical state

Question 2

What do the 3rd characters in categories F10-F19 identify?

Answer 2

The substance

Question 3

When is it okay to assign code F10 Mental and behavioural disorders due to use of alcohol on a patient described as a ‘heavy drinker’?

Answer 3

• If the patient has been advised by the responsible consultant to stop drinking because it will have an adverse effect on their medical condition
• If the reposonsible consultant states that the patient is dependent on alcohol.

Question 4

When should code Z72.1 Alcohol use be assigned instead of a code from F10.-?

Answer 4

If the patient is documented as a heavy drinker with no other reference to a medical condition.

Question 5

What do the 4th character subdivisions for use with categories F70-F79 Mental retardation describe?

Answer 5

The degree of impairment

Question 6

How must a diagnosis of ‘delirium’ together with a documented co-morbidity/diagnosis of ‘dementia’ be coded?

Answer 6

F05.1 Delirium superimposed on dementia

Question 7

How should delirium or acute confusional state be coded when documented?

Answer 7

• Whenever delirium or acute confusional state is documented, it must be coded using the appropriate ICD-10 code
• If the cause is known, this must also be coded
• The correct sequencing depends on the main condition treated or investigated

Question 8

What is the term delirium synonymous with?

Answer 8

the term acute confusional state

Question 9

If a patient has multiple conditions/states classified at 4th character level due to the same substance, how should this be coded?

Answer 9

Each condition/state should be coded
Example:
Alcoholic with acute drunken episode = F10.0 + F10.2

Question 10

When should F17.1 Mental and behavioural disorders due to use of tobacco, harmful use be assigned?

Answer 10

When it is documented that the patient smokes.
If further info is given such as dependence, the 4th character may change.

Question 11

When should Z72.0 Tobacco use not be used?

Answer 11

Must not be assigned for a current smoker.

Question 12

When can codes in category F19.- Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances be assigned?

Answer 12

When 2 or more psychoactive substances are known to be involved and:
* the exact identity of some (or all) of the substances are uncertain or unknown
or
* it is not evident which substance the patient is most dependent upon
or
* it is not possible for the responsible consultant to identify which substance is contributing most to the disorder

Question 13

When a code from F19.- is used and the patient is also a current smoker, how should this be coded?

Answer 13

F17.1 should be coded in combination with the code from F19.-

Question 14

How should a diagnoses of anxiety and depression be coded?

Answer 14

They should be coded seperately, F41.2 should not be used.

Question 15

When can F41.2 Mixed anxiety and depressive disorder be assigned?

Answer 15

For a diagnoses of ‘depression anxiety’ or ‘anxiety depression’.
(Not to be used for diagnoses of depression and anxiety documented seperately.)

Question 16

What is the timeframe after birth in which the code for postnatal depression can be assigned?

Answer 16

There is no timeframe. If there is a diagnosis of postnatal depression, F53.0 should be assigned regardless of how long after the birth of the baby this occurs.

Question 17

If a patient is confirmed to have a true learning disability which codes should be used?

Answer 17

F70-F79

Question 18

If a patient is confirmed to have a scholastic disorder rather than a true learning disability which codes should be used?

Answer 18

F80.- Specific developmental disorders of speech and language
F81.- Specific developmental disorders of scholastic skills

Question 19

If a patient is described as having more than one level of impairment classified at 4th character level in categories F70-F79, how should this be coded?

Answer 19

Code to the most severe level of impairement

Question 20

If a patient is diagnosed with dysfunctions classified to 2 or more of the codes within categories F80.-, F81.- or F82.X, how should this be coded?

Answer 20

A code from category F83.- Mixed specific developmental disorders must be used instead.