ICD-10 Coding

ICD-10 Coding Explained for Therapy Practices

ICD-10 coding stands for the International Classification of Diseases, 10th Revision. It's a standardized system used to classify and document medical diagnoses and procedures. Each condition has a unique alphanumeric code—for example, F84.0 is the code for Autism Spectrum Disorder.

In therapy clinics—like speech therapy, ABA, or occupational therapy—these codes are used for insurance claims, treatment tracking, and clinical documentation.

Why ICD-10 coding matters in therapy practices

For therapy practices, accurate ICD-10 coding is more than just red tape—it’s the bridge between clinical care and administrative flow.

  • Insurance reimbursement: Claims without the correct diagnosis codes get denied or delayed.
  • Compliance: Incorrect coding can lead to audits or penalties.
  • Data tracking: Codes help track patient outcomes and trends over time.
  • Efficiency: Streamlined coding improves billing accuracy and reduces admin load.

How ICD-10 coding works in therapy

  1. Assessment and diagnosis: A licensed clinician assesses the client and assigns a diagnosis based on symptoms, often using DSM-5 mapped to an ICD-10 code.
  2. Code selection: From the diagnosis, the proper ICD-10 code is selected. For example, F90.0 is for ADHD.
  3. Documentation and billing: The code is entered into the EHR or billing platform for claims submission.
  4. Coding updates: ICD-10 is updated yearly; stay current with changes each October.

Examples of ICD-10 codes for therapy

ICD-10 CodeDescriptionF84.0Autism Spectrum DisorderF90.0ADHD, predominantly inattentiveF80.2Mixed receptive-expressive language disorderF93.0Separation anxiety disorder of childhoodR62.50Unspecified lack of expected normal physiological development

FAQs about ICD-10 coding

Do therapists need to assign ICD-10 codes?In most cases, licensed clinicians assign the initial diagnosis, but therapists should understand and use the correct codes in documentation.

Can the wrong code delay insurance payments?Yes. Incorrect or outdated codes commonly lead to claim denials or delays.

What’s the difference between DSM-5 and ICD-10?DSM-5 is used clinically, while ICD-10 is the billing standard. They’re often used together.

Do all insurance plans require ICD-10?Yes. ICD-10-CM is mandatory for all HIPAA-covered entities in the U.S.

Final thoughts

ICD-10 coding might feel like a backend task, but it’s crucial for smooth operations and getting paid on time. For therapy practices juggling clinical care and admin work, having a clear grasp of this coding system can make a big difference.

Whether you're a clinic owner or office admin, make ICD-10 coding part of your workflow literacy—and you’ll see fewer claim headaches and more efficient processes.

External Sources:CDC ICD-10 Lookup