Quick reference
- When to use
- Use F60.5 when the client demonstrates a pervasive, inflexible, and enduring pattern consistent with Obsessive-Compulsive Personality Disorder that deviates from cultural expectations, causes distress or impairment, and is stable over time. Do not assign based on a single clinical encounter.
- Duration
- Personality disorders are enduring patterns — symptoms should be traceable to adolescence or early adulthood. Minimum of several sessions recommended before diagnosing. Reassess periodically as treatment may modify traits.
- Session codes
- Pair with CPT 90834/90837 for individual therapy. DBT programs: 90853 (group), 90834 (individual), plus phone coaching. 90791 for comprehensive evaluation. Long-term treatment is typical.
- Key indicators
- Enduring pattern of inner experience and behavior • Deviates from cultural expectations • Pervasive across situations • Onset in adolescence/early adulthood • Stable and long-standing • Distress or impairment
What F60.5 represents
OCPD is distinct from OCD. It involves a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency.
Key diagnostic criteria
4+ of 8 criteria:
- Preoccupation with details, rules, lists
- Perfectionism interfering with task completion
- Excessive devotion to work
- Overly conscientious about morals/ethics
- Unable to discard worn-out objects
- Reluctant to delegate
- Miserly spending style
- Rigidity and stubbornness
Documentation essentials
Document specific criteria across multiple life domains. Note ego-syntonic nature (patient may not see it as a problem).
Differential diagnosis
Critical to distinguish from OCD (ego-dystonic intrusions vs. ego-syntonic perfectionism).
Treatment planning
CBT, psychodynamic therapy. Address rigidity and perfectionism. Often presents in couples therapy context.
Insurance & billing
Accepted code. Document functional impairment clearly.
Updates & changes
One of the personality disorders retained in the alternative DSM-5 model.
Documentation pitfalls
Don't confuse with OCD. OCPD features are ego-syntonic and characterological.
References
- American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).