ADHD or not? If the patient definitely has it, code it

Why This Topic Matters

ADHD-related visits can involve uncertainty at the time of service, and coding choices may affect compliance, claims processing, and whether the record accurately reflects the reason for the visit. The article is relevant to anyone balancing clinical documentation, diagnosis coding, and payer rules.

Article Sections

1. Coding controversy and professional reactions

   The article opens with criticism from coding professionals about prior guidance and frames the broader compliance concerns around diagnosis reporting.

2. Clinical perspective on ADHD assessment

   This section discusses the challenge of evaluating behavioral and school-related concerns and the variability involved in making an ADHD assessment.

3. ICD-9-CM guidance on symptoms and confirmed diagnoses

   The article reviews general ICD-9-CM rules about when symptom-oriented reporting is appropriate and how that relates to visits when a definitive diagnosis has not yet been established.

4. Coverage, payer policy, and follow-up care

   This section addresses how payer rules, medication management, and follow-up visits can affect billing options in ADHD-related care.

5. Billing honestly and compliance expectations

   The closing section reiterates the importance of accurate reporting under CPT and ICD-9-CM and summarizes the compliance-focused viewpoint of the article.