ICD-10 code F98. 9 for Unspecified behavioral and emotional disorders with onset usually occurring in childhood and adolescence is a medical classification as listed by WHO under the range - Mental, Behavioral and Neurodevelopmental disorders .
R46. 89 - Other Symptoms and Signs Involving Appearance and Behavior [Internet]. In: ICD-10-CM.
ICD-10 Code: F63.81. Intermittent Explosive Disorder (IED) is part of a cluster of diagnoses called the disruptive, impulse-control, and conduct disorders. Disruptive, impulse control and conduct disorders are a group of psychiatric conditions that include: Oppositional Defiant Disorder. Intermittent Explosive Disorder.
R45. 6 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM R45.
1: Restlessness and agitation.
Overview. Intermittent explosive disorder involves repeated, sudden episodes of impulsive, aggressive, violent behavior or angry verbal outbursts in which you react grossly out of proportion to the situation.
Primer. Intermittent Explosive Disorder (IED) is an impulse control disorder characterized by aggressive outbursts that has a rapid onset and, typically, with little to no warning.
Code F41. 9 is the diagnosis code used for Anxiety Disorder, Unspecified. It is a category of psychiatric disorders which are characterized by anxious feelings or fear often accompanied by physical symptoms associated with anxiety.
R46.00.
The ICD-10-CM code for ASD—F84. 0 (autistic disorder)—should be the physician's or psychologist's diagnosis (typically required by payers) of the underlying medical condition, documented in the patient's medical record.
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5. schizophrenia: acute (undifferentiated) (F23. 2)
Some individuals have reported affective changes prior to an outburst (e.g., tension, mood changes, energy changes, etc.). Specialty: Psychiatry. ICD 9 Code: 312.34. Source: Wikipedia.
Use a child code to capture more detail. ICD Code F63.8 is a non-billable code.
To qualify for diagnosis, outbursts must occur about twice a week for at least three months (American Psychiatric Association, 2013).
Common behavioral manifestations of intermittent explosive disorder include road rage, domestic violence, child abuse, and property damage. Violent and aggressive behavior creates a sense of distrust among family members and friends. (Morland, et al., 2013). Relationships are likely to suffer. If the outbursts occur at work, the patient may be faced with employment. Additionally, public and private outbursts, particularly those that cause injury or property damage may result in arrest or other legal trouble (American Psychiatric Association, 2013).
In general, aggressive outbursts tend to decrease as patients age. The average duration of intermittent explosive disorder is between 12 and 20 years. One study of 463 patients found that the average patient experienced 56 aggressive outbursts through the duration of the disorder (Cocarro, 2014).
Intermittent explosive disorder is important to address because a pattern of aggressive behavior can lead to a host of relational and occupational problems. Although many patients resist intervention, cognitive behavioral therapy is an effective treatment for managing anger and learning positive coping skills.
At least 80% of patients diagnosed with experience an explosive episode at least once per year throughout the lifespan (McLaughlin, et al., 2012). Although no direct cause of intermittent explosive disorder has been identified, several studies have linked the disorder to childhood trauma. In addition to being high among those in military service, high rates of intermittent explosive disorder is also found among individuals who has survived abuse, assault, and human rights violations. Refugees and emergency service workers are also at higher risk (Nickerson, et al., 2012). Although alcohol use is not a cause of intermittent explosive disorder, intoxication significantly increases aggressive behavior (Coccaro, 2012).
If the outbursts occur at work, the patient may be faced with employment. Additionally, public and private outbursts, particularly those that cause injury or property damage may result in arrest or other legal trouble (American Psychiatric Association, 2013).
Still, when the patient is cooperative, psychotherapy is extremely helpful.
The DSM-IV-TR was very specific in its definition of Intermittent Explosive Disorder which was defined, essentially, by the exclusion of other conditions . The diagnosis required:
Impulsive behavior, and especially impulsive violence predisposition, have been correlated to a low brain serotonin turnover rate, indicated by a low concentration of 5-hydroxyindoleacetic acid (5-HIAA) in the cerebrospinal fluid (CSF). This substrate appears to act on the suprachiasmatic nucleus in the hypothalamus, which is the target for serotonergic output from the dorsal and median raphe nuclei playing a role in maintaining the circadian rhythm and regulation of blood sugar. A tendency towards low 5-HIAA may be hereditary. A putative hereditary component to low CSF 5-HIAA and concordantly possibly to impulsive violence has been proposed. Other traits that correlate with IED are low vagal tone and increased insulin secretion. A suggested explanation for IED is a polymorphism of the gene for tryptophan hydroxylase, which produces a serotonin precursor; this genotype is found more commonly in individuals with impulsive behavior.
The outbursts cause distress or impairment of functioning or lead to financial or legal consequences (Criterion D) The recurrent outbursts cannot be explained by another mental disorder and are not the result of another medical disorder or substance use (Criterion F)
Verbal aggression (tantrums, verbal arguments, or fights) or physical aggression that occurs twice in a week-long period for at least three months and does not lead to the destruction of property or physical injury (Criterion A1) Three outbursts that involve injury or destruction within a year-long period (Criterion A2)
Bipolar disorder has been linked to increased agitation and aggressive behavior in some individuals, but for these individuals, aggressiveness is limited to manic and/or depressiv e episodes, whereas individuals with IED experience aggressive behavior even during periods with a neutral or positive mood.