F90.0 ICD-10 Code: Coprehensive Guide to Attention-Deficit Hyperactivity Disorder, Predominantly Inattentive Type
GUIDE
In the realm of mental health, accurate diagnosis and coding are crucial for effective treatment and proper documentation. This comprehensive guide focuses on ICD-10 code F90.0, which represents Attention-Deficit Hyperactivity Disorder (ADHD), Predominantly Inattentive Type. We'll explore the diagnostic criteria, symptoms, treatment options, and important considerations for healthcare providers working with individuals who have this subtype of ADHD.
Understanding ICD-10 code F90.0
ICD-10 code F90.0 is used to designate Attention-Deficit Hyperactivity Disorder, Predominantly Inattentive Type. This code is part of the broader category of mental disorders, specifically neurodevelopmental disorders, in the International Classification of Diseases, 10th Revision (ICD-10).
The inattentive type of ADHD is characterized by symptoms of inattention without significant hyperactivity or impulsivity. It's important to note that this diagnosis aligns with the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which refers to this presentation as "ADHD, Predominantly Inattentive Presentation."
Diagnostic Criteria for Inattentive ADHD
To meet the diagnostic criteria for Inattentive ADHD (F90.0), an individual must display at least six of the following inattentive symptoms for children up to age 16, or five for adolescents 17 and older and adults.
These symptoms should persist for at least six months and be inconsistent with the individual's developmental level:
Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
Often has difficulty sustaining attention in tasks or play activities
Often does not seem to listen when spoken to directly
Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace
Often has difficulty organizing tasks and activities
Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
Often loses things necessary for tasks or activities
Is often easily distracted by extraneous stimuli
Is often forgetful in daily activities
It's crucial to note that these symptoms must be present in multiple settings (e.g., home, school, work) and significantly impact social, academic, or occupational functioning.
Differentiating Inattentive ADHD from Other ADHD Subtypes
ICD-10 code F90.0 specifically refers to the predominantly inattentive type of ADHD. It's important to distinguish this from other ADHD subtypes:
F90.0: Attention-Deficit Hyperactivity Disorder, Predominantly Inattentive Type
F90.1: Attention-Deficit Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type
F90.2: Attention-Deficit Hyperactivity Disorder, Combined Type
The key differences between these subtypes are:
Predominantly Inattentive Type (F90.0):
Primarily exhibits inattentive symptoms
Little to no hyperactivity or impulsivity
Often overlooked due to less disruptive behavior
Predominantly Hyperactive-Impulsive Type (F90.1)
Mainly displays hyperactive and impulsive behaviors
Fewer inattentive symptoms
More commonly diagnosed in young children
Combined Type (F90.2)
Meets criteria for both inattentive and hyperactive-impulsive presentations
Also referred to as "combined presentation" in the DSM-5
Often considered the most severe form of ADHD
The combined presentation (F90.2) is particularly noteworthy as it encompasses both the inattentive and hyperactive-impulsive symptoms. Individuals with this subtype struggle with focus and attention while also exhibiting hyperactivity and impulsivity. This can lead to more significant impairments in daily functioning compared to the predominantly inattentive or hyperactive-impulsive types alone.
For those with the combined presentation, treatment often needs to address both inattentive and hyperactive-impulsive symptoms, potentially requiring a more comprehensive approach that might include a combination of medication, behavioral interventions, and environmental modifications.
Impact on Daily Activities and Functioning
Inattentive ADHD can significantly affect an individual's daily activities and occupational functioning. Common challenges include:
Difficulty completing tasks or assignments
Trouble managing time and meeting deadlines
Struggles with organization and prioritization
Frequent forgetfulness in daily responsibilities
Difficulty paying attention during conversations or meetings
Challenges in following complex instructions
These difficulties can impact academic performance, work productivity, and social relationships, making it crucial to identify and address inattentive ADHD symptoms early.
Assessment and Diagnosis
Diagnosing inattentive ADHD requires a comprehensive evaluation by a qualified mental health professional. The assessment process typically includes:
Clinical interview with the patient (and parents/caregivers for children)
Review of medical and developmental history
Behavioral observations
Standardized rating scales and questionnaires
Cognitive and academic assessments (when appropriate)
Consideration of alternative explanations for symptoms
It's essential to rule out other conditions that may mimic ADHD symptoms, such as anxiety disorders, mood disorders, or learning disabilities.
Assessment Tools for Inattentive ADHD
Accurate diagnosis of inattentive ADHD (F90.0) relies on comprehensive assessment using validated tools. Here are some widely used assessment instruments:
Conners' Rating Scales-Revised (CRS-R): These scales assess ADHD symptoms and associated problems in children and adolescents. They include versions for parents, teachers, and adolescents.
ADHD Rating Scale-5 (ADHD-RS-5): This scale assesses the 18 symptoms of ADHD as defined by the DSM-5. It has forms for home and school settings.
Vanderbilt ADHD Diagnostic Rating Scale (VADRS): This scale includes versions for parents and teachers, assessing both ADHD symptoms and common comorbid conditions.
Brown Attention-Deficit Disorder Scales (BADDS): These scales focus on executive function impairments associated with ADHD, particularly useful for identifying inattentive symptoms.
Behavior Rating Inventory of Executive Function (BRIEF): This assesses executive function behaviors in home and school environments, crucial for understanding inattentive ADHD.
Test of Variables of Attention (TOVA): A computerized continuous performance test that measures attention and impulse control.
Quotient ADHD System: A computer-based assessment that measures motion and attention.
Barkley Adult ADHD Rating Scale-IV (BAARS-IV): Specifically designed for assessing ADHD symptoms in adults.
When using these tools, it's crucial to consider the individual's developmental level and gather information from multiple sources (e.g., self-report, parent/caregiver report, teacher report) to get a comprehensive picture of the individual's functioning across different settings.
Treatment Approaches
Treatment for inattentive ADHD often involves a multimodal approach, which may include:
Medication: Stimulant medications (e.g., methylphenidate, amphetamines) or non-stimulant medications (e.g., atomoxetine) may be prescribed to manage symptoms.
Behavioral Therapy: Techniques such as cognitive-behavioral therapy (CBT) can help individuals develop strategies to manage inattention and improve organizational skills.
Educational Interventions: Accommodations and support in academic settings can help individuals with inattentive ADHD succeed in their studies.
Skills Training: Programs focusing on time management, organization, and study skills can be beneficial.
Psychoeducation: Educating individuals and their families about ADHD can improve understanding and support.
Lifestyle Modifications: Regular exercise, proper sleep hygiene, and a balanced diet can help manage symptoms.
The treatment plan should be tailored to the individual's specific needs, considering their age, symptom severity, and any co-occurring conditions.
Considerations for Different Age Groups
The presentation and impact of inattentive ADHD can vary across different developmental stages:
Children: May struggle with completing schoolwork, following instructions, and staying organized.
Adolescents: May face challenges with time management, study skills, and maintaining focus on long-term projects.
Adults: May experience difficulties in work performance, relationship management, and daily responsibilities.
Treatment approaches and interventions should be adjusted to address the specific challenges faced at each developmental level.
Comorbidities and Differential Diagnosis
Inattentive ADHD often co-occurs with other mental health conditions, including:
Anxiety disorders
Mood disorders (e.g., depression)
Learning disabilities
Sleep disorders
It's crucial to differentiate inattentive ADHD from other conditions that may present with similar symptoms, such as:
Pervasive Developmental Disorders (e.g., Autism Spectrum Disorder)
Specific Learning Disorders
Anxiety or Mood Disorders
Accurate differential diagnosis is essential for developing an effective treatment plan.
Coding and Documentation Best Practices
When using ICD-10 code F90.0, consider the following best practices:
Clearly document the specific inattentive symptoms observed
Note the duration and pervasiveness of symptoms across different settings
Include any formal assessments or rating scales used in the diagnostic process
Document the impact of symptoms on the individual's functioning
Clearly differentiate from other ADHD subtypes or related conditions
Update the diagnosis if the presentation changes over time (e.g., to combined type)
Proper documentation supports accurate coding and helps ensure appropriate treatment planning and continuity of care.
Leveraging AI Documentation Tools for ADHD Management
In recent years, AI clinical documentation tools like Supanote have emerged as valuable assets for mental health professionals managing ADHD cases. These tools can significantly cut down documentation time, allowing clinicians to focus more on patient care. Here's how AI documentation tools can be particularly useful in managing inattentive ADHD cases:
Efficient Progress Notes: AI tools can help generate detailed progress notes quickly, capturing key information about symptom progression, medication effectiveness, and treatment plan adjustments.
Symptom Tracking: Advanced AI systems can analyze notes over time to identify patterns in symptom presentation, potentially alerting clinicians to changes that might warrant adjustments in the treatment approach.
Medication Management: AI tools can assist in tracking medication changes, dosages, and reported side effects, providing a clear overview of the patient's medication history.
By integrating these advanced tools into their practice, mental health professionals can enhance their ability to provide high-quality, personalized care for individuals with inattentive ADHD, while also maintaining thorough and efficient documentation.
Frequently Asked Questions
Q: Can adults be diagnosed with inattentive ADHD (F90.0)?
A: Yes, adults can be diagnosed with inattentive ADHD. However, symptoms must have been present since childhood, even if they were not previously diagnosed.
Q: How is inattentive ADHD different from "laziness" or lack of motivation?
A: Inattentive ADHD is a neurodevelopmental disorder with specific diagnostic criteria. Unlike laziness, individuals with inattentive ADHD often want to focus and complete tasks but struggle due to their symptoms.
Q: Can inattentive ADHD change to other types of ADHD over time?
A: Yes, it's possible for the presentation to change. For example, an individual initially diagnosed with inattentive type might later meet criteria for combined type if hyperactive-impulsive symptoms develop.
Q: How does inattentive ADHD differ in girls compared to boys?
A: Girls are more likely to be diagnosed with inattentive ADHD compared to boys. Their symptoms may be less noticeable, potentially leading to underdiagnosis.
Q: Can inattentive ADHD coexist with giftedness or high intelligence?
A: Yes, individuals with high intelligence can also have inattentive ADHD. In fact, their intelligence may sometimes mask their ADHD symptoms, leading to later diagnosis.
Remember, while this guide provides comprehensive information about ICD-10 code F90.0 and inattentive ADHD, it's essential to consult with qualified mental health professionals for diagnosis and treatment planning.
References
1. https://www.icd10data.com/ICD10CM/Codes/F01-F99/F90-F98/F90-/F90.0