Quick reference
- When to use
- Use F90.2 when the client meets diagnostic criteria for ADHD, Combined Presentation. For ADHD, confirm symptom presence before age 12. For ASD, document early developmental history. Obtain collateral information when possible.
- Duration
- These are chronic, lifelong conditions. ADHD symptoms must have been present before age 12 with current impairment in 2+ settings. ASD symptoms must be present in early development. Reassess annually for treatment planning.
- Session codes
- Pair with CPT 90791 (comprehensive evaluation), 90834/90837 (therapy), 96127 (screening tools like Vanderbilt, ASRS). Neuropsychological testing: 96136/96137. Parent training: 90847.
- Key indicators
- ADHD: inattention, hyperactivity, impulsivity across settings • ASD: social communication deficits, restricted/repetitive behaviors • Onset in developmental period • Functional impairment across settings
What F90.2 represents
The most commonly diagnosed ADHD presentation, featuring significant symptoms of both inattention and hyperactivity-impulsivity. This is what most people think of when they hear 'ADHD.'
Key diagnostic criteria
- 6+ inattention symptoms AND 6+ hyperactivity-impulsivity symptoms (5+ each for age 17+)
- Duration 6+ months
- Onset before age 12
- Present in 2+ settings
- Functional impairment
Documentation essentials
Document symptoms from both domains. Use standardized rating scales. Record functional impact across settings.
Differential diagnosis
Rule out anxiety, mood disorders, learning disabilities, sleep disorders, and trauma-related presentations.
Treatment planning
Multimodal treatment: medication, behavioral therapy, educational accommodations, skills training.
Insurance & billing
Well-accepted. Thorough documentation supports ongoing treatment.
Updates & changes
DSM-5 terminology changed from 'subtypes' to 'presentations' to reflect that presentation may change over time.
Documentation pitfalls
Don't assume ADHD explains all academic or behavioral difficulties. Assess for comorbidities.
References
- American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).