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ADHD Diagnosis Codes: Essential Guide to ICD-10 Classification

Stanley Efrem

Aug 27, 2025

When diagnosing and documenting ADHD, proper diagnosis codes are essential for accurate patient records and insurance claims. According to the CDC, approximately 7 million U.S. children aged 3–17 years (11.4%) were diagnosed with ADHD in a 2022 national parent survey . With such prevalence, understanding how to correctly code this condition is crucial for healthcare providers.

The ICD-10 classification system presents unique challenges when coding ADHD, as it traditionally didn't formally recognize ADHD but instead included diagnostic criteria for hyperkinetic disorder (HKD) . Additionally, ADHD is categorized into three distinct subtypes: Hyperactive/impulsive type, Inattentive type, and Combined type , each with its specific ADHD ICD-10 code. Specifically, these codes fall under the F90 category, which includes F90.0, F90.1, F90.2, F90.8, and F90.9 .

In this comprehensive guide, you'll learn everything about ADHD diagnosis codes, from understanding the different subtypes to applying the correct ICD-10 classifications. Since ADHD diagnosis requires formal testing from a licensed and trained professional , knowing how to translate clinical findings into appropriate codes is vital for your practice. Whether you're dealing with ADHD inattentive type or the more common combined type, this article will equip you with the knowledge to code with confidence and precision.

Understanding ADHD and Its Subtypes

Attention-deficit/hyperactivity disorder (ADHD) manifests differently across individuals, which is why the ICD-10 classification system divides it into distinct subtypes based on symptom presentation. This nuanced approach helps clinicians provide more accurate diagnoses and treatment plans.

ADHD inattentive type ICD 10 explained

The inattentive presentation of ADHD (F90.0) primarily involves difficulty focusing and staying organized. Individuals with this subtype often miss details, become easily distracted, and struggle with completing tasks [1]. They may appear to be daydreaming or seem forgetful about daily activities. Furthermore, this subtype is more commonly diagnosed in girls and women than the other presentations [2].

ADHD hyperactive-impulsive type overview

Hyperactive-impulsive ADHD (F90.1) manifests as constant movement, excessive talking, and acting without thinking first [3]. Children with this subtype may be described as if they are "driven by a motor," running around excessively even when inappropriate [4]. Boys and men tend to display more hyperactive and impulsive symptoms than girls and women [1]. Notably, this presentation is the most common form diagnosed in preschoolers [4].

What is ADHD combined type?

Combined type ADHD (F90.2) includes significant symptoms of both inattention and hyperactivity-impulsivity. To receive this diagnosis, individuals must demonstrate at least six symptoms from each category (five for adults 17+) [5]. This is the most prevalent form, with approximately 70% of adults with ADHD showing the combined presentation [5]. For many people, the combined type creates challenges across multiple life domains, affecting both attention regulation and behavioral control.

How symptoms vary by age and setting

For a proper ADHD diagnosis, symptoms must be present in at least two settings (such as home, school, or work) and interfere with daily functioning [1]. Moreover, ADHD symptoms must begin in childhood before age 12, though diagnosis can occur at any age [1].

As individuals grow, symptom presentation often evolves. Children typically exhibit more hyperactivity, while adolescents might display restlessness or fidgeting instead [1]. Adults generally show less hyperactivity but continue experiencing inattention and internal restlessness [6]. Throughout all stages, symptoms can become more severe when demands increase, particularly affecting organization, time management, and social relationships [6].

ICD-10 Codes for ADHD: Full Breakdown

The ICD-10 classification system organizes ADHD under the F90 category, providing specific codes that correspond to different clinical presentations. These codes enable healthcare providers to document diagnoses with precision for both clinical and insurance purposes.

F90.0 – Predominantly inattentive type

Code F90.0 designates attention-deficit hyperactivity disorder, predominantly inattentive type. This diagnosis applies when symptoms of inattention have been present for at least six months, but criteria for hyperactivity-impulsivity haven't been met during that period. Essentially, this code covers what was formerly known as ADD (Attention Deficit Disorder). The inattentive presentation is most frequently diagnosed in adult women and girls, with patients often struggling to concentrate, organize tasks, and finish activities.

F90.1 – Predominantly hyperactive type

F90.1 identifies attention-deficit hyperactivity disorder, predominantly hyperactive-impulsive type. In this presentation, symptoms of hyperactivity and impulsivity dominate, with fewer inattentive symptoms. Patients coded under F90.1 typically exhibit fidgeting, excessive talking, restlessness, and difficulty waiting their turn. This code is applicable when hyperactive-impulsive symptoms have been present, but inattentive criteria haven't been fully met.

F90.2 – Combined type

The F90.2 code represents ADHD combined type, the most prevalent form of the disorder. This diagnosis is appropriate when both inattentive and hyperactive-impulsive symptoms have persisted for at least six months. For billing purposes, F90.2 is a specific, billable code that healthcare providers can use to indicate a diagnosis for reimbursement.

F90.8 – Other type

F90.8 designates attention-deficit hyperactivity disorder, other type. This code is used for atypical presentations that don't clearly fall under the predominantly inattentive, predominantly hyperactive, or combined types. Consequently, F90.8 may include presentations such as adult residual ADHD or other variants that meet general ADHD criteria but with unique symptom patterns.

F90.9 – Unspecified type

Code F90.9 covers attention-deficit hyperactivity disorder, unspecified type. This billable code is appropriate when ADHD symptoms are evident but haven't been fully classified into a specific subtype. Indeed, F90.9 might be used when documentation lacks detail for subtype specification or when further clinical assessment is needed.

Coding Rules and Exclusions You Must Know

Proper ADHD coding requires understanding several critical rules and exclusions within the ICD-10 system. These guidelines ensure accurate diagnosis documentation and appropriate insurance reimbursement for patient care.

Understanding Excludes2 notes

In ICD-10 coding, Excludes2 notes indicate conditions that may coexist with ADHD. Unlike Excludes1 notes (which represent mutually exclusive diagnoses), Excludes2 means you can code both conditions simultaneously when clinically appropriate [7]. For ADHD specifically, the Excludes2 notes include anxiety disorders (F40.-, F41.-), mood disorders (F30-F39), pervasive developmental disorders (F84.-), and schizophrenia (F20.-) [8]. Therefore, when these conditions occur alongside ADHD, you should code them separately.

Common co-occurring conditions

More than two-thirds of individuals with ADHD have at least one coexisting condition [9]. The most prevalent include:

Oppositional defiant disorder (ODD) - affects approximately 40% of individuals with ADHD [9]
Conduct disorder - occurs in 27% of children, 45-50% of adolescents, and 20-25% of adults with ADHD [9]
Anxiety disorders - present in up to 30% of children and 53% of adults with ADHD [9]
Depression - affects approximately 14% of children and 47% of adults with ADHD [9]
Learning disorders - present in up to 50% of children with ADHD [9]

When not to use ADHD codes

Firstly, avoid using ADHD codes for conditions with similar symptoms but different origins. These include age-related cognitive decline (G31.84), traumatic brain injury (S06.9X9A), and bipolar disorder (F31.9) [10]. Likewise, conditions such as sleep disorders causing attention problems should not receive ADHD diagnoses [11]. Prior to establishing a definitive ADHD diagnosis, use symptom-based codes rather than "rule out ADHD" [12].

How to code ADD correctly

Despite common usage, "ADD" is not a separate diagnosis in ICD-10. For patients with primarily inattentive symptoms, use F90.0 (Attention-deficit hyperactivity disorder, predominantly inattentive type) [13]. Importantly, never use F90.8 or F90.9 to document ADD, as both specifically mention hyperactivity in their descriptors [14]. F90.2 (combined type) is appropriate only when both inattentive and hyperactive-impulsive symptoms are significant [14].

Best Practices for Accurate ADHD Coding

Mastering ADHD coding practices saves both time and money, as healthcare practices lose an average of $47,000 annually due to incorrect ADHD coding [10]. With attention to detail and proper procedures, you can avoid these costly errors.

Code to the highest specificity

Above all, use the most specific code possible for ADHD diagnosis. Only use F90.9 temporarily when insufficient information exists to determine the specific ADHD subtype [10]. In reality, you should transition to more specific codes (F90.0, F90.1, or F90.2) within 30 days to avoid Medicare contractor reviews and reimbursement delays [10]. For what was formerly known as ADD, always use F90.0 (predominantly inattentive type) [14].

Ensure proper documentation

Comprehensive documentation serves as the foundation for accurate coding. Your clinical notes should:

Specify the ADHD type (inattentive, hyperactive, or combined) [10]
Document symptoms in specific behavioral terms [3]
Include feedback from multiple settings (home, school, work) [3]
Track treatment response systematically [3]

Use symptom-based codes when diagnosis is unclear

In view of diagnostic uncertainty, use symptom-based codes. When ADHD is suspected but not confirmed, report codes for attention and concentration deficit (R41.840) [15]. Never assign a diagnosis code for conditions documented as "rule out" or "working diagnosis" [14].

Tips for working with insurance payers

To improve claim acceptance:

Review payer contracts to identify covered ADHD services [15]
Verify appropriate code selection before submission [10]
Document and code comorbid conditions separately [10]
Track and appeal erroneous denials [15]

Conclusion

Mastering ADHD diagnosis codes stands essential for healthcare providers who regularly treat this common neurodevelopmental disorder. Throughout this guide, you've learned how the ICD-10 classification system categorizes ADHD into specific subtypes, each with its corresponding code. Armed with this knowledge, you can now properly document and bill for inattentive (F90.0), hyperactive-impulsive (F90.1), and combined (F90.2) presentations.

Accurate coding therefore directly impacts both patient care and practice revenue. When you apply the appropriate F90-series codes and document thoroughly, you help ensure patients receive proper treatment while maximizing legitimate reimbursement. Additionally, understanding excludes2 notes allows you to correctly code co-occurring conditions that frequently accompany ADHD.

Certainly, the distinction between temporary symptom-based codes and definitive ADHD diagnoses matters significantly. Rather than using unspecified codes long-term, strive to code to the highest specificity based on comprehensive assessments across multiple settings.

While ADHD coding might seem complex at first glance, consistent application of the practices outlined in this guide will streamline your documentation process. After all, precision in diagnosis coding ultimately benefits everyone—healthcare providers avoid costly errors, insurance claims process smoothly, and patients receive appropriate care based on their specific ADHD presentation.

Key Takeaways

Understanding ADHD diagnosis codes is crucial for healthcare providers, as proper coding ensures accurate patient records and maximizes insurance reimbursement while avoiding costly errors.

• Use specific F90 codes: F90.0 for inattentive type, F90.1 for hyperactive type, F90.2 for combined type • Code to highest specificity within 30 days to avoid Medicare reviews and reimbursement delays • Document symptoms across multiple settings with behavioral terms and treatment response tracking • Code comorbid conditions separately using Excludes2 notes for anxiety, mood disorders, and learning disabilities • Use symptom-based codes (R41.840) when ADHD is suspected but not confirmed, never "rule out" diagnoses

Healthcare practices lose an average of $47,000 annually due to incorrect ADHD coding, making precision essential for both clinical care and financial health. Remember that what was formerly called ADD should always be coded as F90.0 (predominantly inattentive type), and comprehensive documentation serves as the foundation for successful claims processing.

FAQs

What are the main ICD-10 codes for ADHD?

The main ICD-10 codes for ADHD are F90.0 for predominantly inattentive type, F90.1 for predominantly hyperactive type, F90.2 for combined type, F90.8 for other type, and F90.9 for unspecified type.

How does ADHD presentation differ between children and adults?

Children typically exhibit more hyperactivity, while adults generally show less hyperactivity but continue experiencing inattention and internal restlessness. Symptoms can become more severe when demands increase, particularly affecting organization, time management, and social relationships.

What are some common conditions that co-occur with ADHD?

Common conditions that co-occur with ADHD include oppositional defiant disorder, conduct disorder, anxiety disorders, depression, and learning disorders. More than two-thirds of individuals with ADHD have at least one coexisting condition.

How should healthcare providers code for what was formerly known as ADD?

For what was formerly known as ADD (Attention Deficit Disorder), healthcare providers should always use the code F90.0, which represents attention-deficit hyperactivity disorder, predominantly inattentive type.

What are some best practices for accurate ADHD coding?

Best practices for accurate ADHD coding include coding to the highest specificity, ensuring proper documentation of symptoms and treatment responses, using symptom-based codes when diagnosis is unclear, and understanding how to work effectively with insurance payers to improve claim acceptance.