Cracking the Code
Coding Depression and Anxiety
When a patient has both depression and anxiety, it is important to remember that there is not an assumed relationship between the two conditions. If a provider’s documentation has not established a linkage between the depression and the anxiety, then it is appropriate to report F32.9, major depressive disorder, single episode, unspecified and F41.9, anxiety disorder, unspecified to capture both conditions. However, if a provider’s documentation DOES establish a linkage between the two conditions, then it is appropriate to assign the combination diagnosis code F41.8, other specified anxiety disorders to capture both conditions. This code assignment also includes anxiety depression and mixed anxiety and depressive disorder.
Q: A 20-year-old college male reports to the ED with complaints of feeling depressed and stressed about school. He has concerns with flunking out and spends a lot of time playing video games to distract himself from experiencing chaotic thoughts. He rarely attends class and avoids interacting with people. A psychiatric evaluation is completed, and the patient has a final diagnosis of depression and anxiety.
A: F32.9, major depressive disorder, single episode, unspecified
F41.9, anxiety disorder, unspecified
F41.9, anxiety disorder, unspecified
Reference: AHA Coding Clinic First Quarter 2021, pages 10-11: Depression and anxiety