F43.20
BillableAdjustment disorder, unspecified
HCC Category Mapping
RxHCCHCC 133 — Personality Disorders, Anxiety, and Other Specified Mental Disorders
0.000What This Code Means
A temporary emotional or behavioral problem that develops in response to a specific identifiable stressor, without specification of the predominant symptoms.
Coding Tips
Clinical Significance
Adjustment disorder, unspecified, is used when a patient develops emotional or behavioral symptoms in response to an identifiable stressor but the specific subtype (depressed mood, anxiety, mixed, conduct disturbance) is not documented. This code should prompt a query for specification since the symptom pattern is usually identifiable.
Documentation Requirements
- ✓Identifiable stressor documented with temporal relationship to symptom onset
- ✓Emotional or behavioral symptoms developing within 3 months of the stressor
- ✓Symptoms are clinically significant (marked distress beyond expected or functional impairment)
- ✓Symptoms do not meet criteria for another specific mental disorder
- ✓Symptoms do not represent normal bereavement
- ✓Expected to resolve within 6 months after the stressor or its consequences end
Commonly Confused Codes
F43.21 (Adjustment disorder with depressed mood) — Use when depressed mood predominatesF43.22 (Adjustment disorder with anxiety) — Use when anxiety predominatesF43.23 (Adjustment disorder with mixed anxiety and depressed mood) — Use when both are presentF32.9 (Major depressive disorder, single episode, unspecified) — MDD is more severe and may persist without a stressor; adjustment disorder is reactiveF43.10 (PTSD, unspecified) — PTSD requires a criterion A trauma; adjustment disorder can follow any stressor
Code Hierarchy
└F43Reaction to severe stress, and adjustment disorders└F43.2Adjustment disorders└F43.20Adjustment disorder, unspecified
└F43.20Adjustment disorder, unspecified