F91.3

Billable

Oppositional defiant disorder

HCC Category Mapping

RxHCCHCC 133 — Personality Disorders, Anxiety, and Other Specified Mental Disorders

0.000

What This Code Means

A behavioral disorder characterized by a persistent pattern of defiance, arguing, anger, and refusal to comply with authority figures, without serious aggression or rule-breaking.

Coding Tips

•Distinguish from conduct disorder by confirming absence of serious aggression, property destruction, or violation of others' rights
•Document specific oppositional behaviors such as arguing, defiance, and anger outbursts

Clinical Significance

Oppositional defiant disorder (ODD) is characterized by a frequent and persistent pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness toward authority figures lasting at least 6 months. ODD is one of the most common childhood behavioral disorders, frequently co-occurring with ADHD, and may progress to conduct disorder. Early intervention with behavioral therapy and parent training is effective in many cases.

Documentation Requirements

✓Provider documentation of oppositional defiant disorder diagnosis
✓Evidence of persistent pattern (at least 6 months) of angry/irritable mood, argumentative/defiant behavior, or vindictiveness
✓Documentation that the behavior is observed with at least one individual who is not a sibling
✓Evidence of functional impairment in social, academic, or occupational settings
✓Assessment for comorbid ADHD and treatment plan including behavioral interventions

Commonly Confused Codes

F91.1 — Conduct disorder, childhood-onset type; conduct disorder involves more serious violations (aggression, destruction, deceit, theft) beyond defiance F91.2 — Conduct disorder, adolescent-onset type; same distinction — conduct disorder is more severe F90.x — ADHD; ADHD frequently co-occurs with ODD but they are separate diagnoses that should be coded independently F63.81 — Intermittent explosive disorder; IED involves disproportionate aggressive outbursts, not a persistent defiant pattern

Code Hierarchy

└F91Conduct disorders └F91.3Oppositional defiant disorder

└F91.3Oppositional defiant disorder