F43.23
BillableAdjustment disorder with mixed anxiety and depressed mood
HCC Category Mapping
RxHCCHCC 133 — Personality Disorders, Anxiety, and Other Specified Mental Disorders
0.000What This Code Means
A condition where a person experiences both anxiety and depressed mood in response to a specific identifiable stressor, with both symptoms being equally prominent.
Coding Tips
- •Document that both anxiety and depressed mood are present and significant to justify this code over F43.21
- •Identify and document the specific stressor that precipitated the adjustment disorder
Clinical Significance
Adjustment disorder with mixed anxiety and depressed mood captures reactive emotional disturbance where both anxiety and depression are prominent but neither alone meets criteria for a full depressive or anxiety disorder. This is one of the most commonly diagnosed adjustment disorder subtypes and reflects the typical mixed emotional response to significant life stressors.
Documentation Requirements
- ✓Identifiable stressor documented
- ✓Both anxiety and depressed mood present as significant symptoms
- ✓Neither anxiety nor depression alone meets criteria for a specific anxiety or depressive disorder
- ✓Symptom onset within 3 months of the stressor
- ✓Functional impairment or marked distress
- ✓Current treatment plan addressing both anxiety and depressive symptoms
Commonly Confused Codes
F43.21 (Adjustment disorder with depressed mood) — Use F43.21 when depression predominates with minimal anxietyF43.22 (Adjustment disorder with anxiety) — Use F43.22 when anxiety predominates with minimal depressionF41.8 (Other specified anxiety disorders) — Mixed anxiety and depressive disorder (F41.8) is used when the mixed state is chronic, not reactiveF32.9 (Major depressive disorder, single episode, unspecified) — If depressive symptoms meet MDD criteria, code MDD rather than adjustment disorder
Code Hierarchy
└F43Reaction to severe stress, and adjustment disorders└F43.2Adjustment disorders└F43.23Adjustment disorder with mixed anxiety and depressed mood
└F43.23Adjustment disorder with mixed anxiety and depressed mood