F91.1

HCC Category Mapping

What This Code Means

A behavioral disorder that begins in childhood (typically before age 10) characterized by persistent rule-breaking, aggression, and violation of others' rights across multiple settings.

Coding Tips

• •Verify onset before age 10 and document symptoms present in home, school, and/or community settings
• •Distinguish from adolescent-onset type (F91.2) by confirming early childhood onset

Clinical Significance

Childhood-onset conduct disorder is defined by the presence of at least one conduct disorder symptom prior to age 10 years. This subtype carries a worse prognosis compared to adolescent-onset type, with higher rates of physical aggression, persistent antisocial behavior into adulthood, and development of antisocial personality disorder. Early identification enables intensive intervention that may alter the trajectory toward adult antisocial outcomes.

Documentation Requirements

• ✓Provider documentation of conduct disorder with at least one characteristic symptom present before age 10
• ✓Evidence of persistent pattern of behavior violating others' rights or major age-appropriate societal norms
• ✓Documentation of the age of onset of conduct symptoms
• ✓Assessment of severity (mild, moderate, severe) based on number and seriousness of conduct problems
• ✓Treatment plan including evidence-based interventions (multisystemic therapy, parent management training)

Commonly Confused Codes