Quick reference
- When to use
- Use F43.0 when the client's presentation is directly linked to an identifiable stressor or traumatic event and meets the specific criteria for Acute Stress Disorder. Document the qualifying event or stressor clearly.
- Duration
- PTSD: symptoms >1 month post-trauma. Acute Stress: 3 days to 1 month. Adjustment Disorders: onset within 3 months of stressor, resolves within 6 months after stressor ends. Reassess timeline regularly.
- Session codes
- Pair with CPT 90837 (60-min, preferred for trauma processing), 90834 (45-min for stabilization), or 90791 (initial evaluation). Add 96127 for PCL-5 or PHQ-9 screening. EMDR/exposure sessions often require 90837.
- Key indicators
- Intrusive memories or flashbacks • Avoidance of trauma reminders • Negative mood or cognition changes • Hyperarousal or hypervigilance • Sleep disturbance • Dissociative symptoms • Clear temporal link to stressor
What F43.0 represents
Acute Stress Disorder is the initial response to trauma, occurring within 3 days to 1 month after exposure. It shares many features with PTSD but has a shorter time frame. Not everyone with ASD develops PTSD, but it is a significant risk factor.
Key diagnostic criteria
- Exposure to actual/threatened death, serious injury, or sexual violence
- Nine or more symptoms from five categories: intrusion, negative mood, dissociation, avoidance, arousal
- Duration: 3 days to 1 month after trauma
- Clinically significant distress/impairment
Documentation essentials
Document the traumatic event, onset timing, and specific symptoms. Note dissociative features. Plan for reassessment at 1 month.
Differential diagnosis
Distinguish from normal stress response, brief psychotic disorder, PTSD (if > 1 month), and adjustment disorder.
Treatment planning
Trauma-focused CBT is recommended. Debriefing alone is not supported. Watchful waiting may be appropriate for less severe presentations.
Insurance & billing
Accepted code. Document timing relative to trauma. Note that diagnosis should transition to PTSD or resolution after 1 month.
Updates & changes
ASD criteria were simplified in DSM-5 to focus on overall symptom count rather than specific cluster requirements.
Documentation pitfalls
Don't maintain this diagnosis beyond 1 month. Either transition to PTSD or note symptom resolution.
References
- American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).