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Icd-10 Codes for PTSD

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PTSD & ICD-10: what clinicians need to know

Post-traumatic stress disorder (PTSD) is grouped in ICD-10-CM under F43 — Reaction to severe stress, and adjustment disorders. PTSD itself uses the F43.1x family with three primary, billable subcodes:

  • F43.10 — PTSD, unspecified
  • F43.11 — PTSD, acute (symptoms < 3 months)
  • F43.12 — PTSD, chronic (symptoms ≥ 3 months)

ICD-10 differentiates PTSD from related conditions such as F43.0 acute stress reaction (short-lived, immediate response) and F43.2 adjustment disorders (maladaptive response to stressors that do not meet PTSD criteria). Accurate coding supports medical necessity, reduces denials, and improves outcome tracking.

Authoritative references: WHO ICD-10 browser • NIMH: PTSD • APA DSM-5

PTSD diagnostic flow (at a glance)

This visual summarizes a typical pathway clinicians see as trauma reactions consolidate into PTSD. Use it to orient your intake and follow-up documentation.

Trauma Intrusion (B) Avoidance (C) Negative mood/cognition (D) Arousal/reactivity (E)
Map symptoms across DSM-5 clusters to support medical necessity and progress measures.

ICD-10 codes for PTSD (F43.1x)

F43.10 — PTSD, unspecified

Use when PTSD criteria are met but acuity (acute vs chronic) is not yet determined or insufficiently documented. Helpful during initial evaluation; update once duration is clear.

Billable • Requires trauma exposure + core symptoms • Add functional impact

F43.11 — PTSD, acute

Use when symptoms persist for less than 3 months after the traumatic exposure. Document onset, DSM-5 symptom clusters, and functional impairment (work, school, social).

Billable • Duration < 3 months • Consider initial med/therapy plan

F43.12 — PTSD, chronic

Use when symptoms persist for 3 months or longer. Common for ongoing psychotherapy or med-management episodes. Pair with outcomes (PCL-5, sleep/avoidance metrics).

Billable • Duration ≥ 3 months • Align with treatment plan reviews
Related codes you might consider
  • F43.0 — Acute stress reaction (short-term, immediate response)
  • F43.2x — Adjustment disorders (stressor-linked, sub-PTSD)

Reference: WHO ICD-10: F43.1

ICD-10 vs DSM-5: how PTSD coding differs

ICD-10-CM is the billing standard; DSM-5 provides richer diagnostic criteria. Both require trauma exposure and symptom persistence beyond one month, with distress/functional impairment.

CategoryICD-10-CMDSM-5
CodeF43.1x (10/11/12)309.81 (map to F43.1x for billing)
StructureFamily by acuity (unspecified/acute/chronic)Four clusters (B–E): intrusion, avoidance, negative mood/cognition, arousal
Duration> 1 month after trauma> 1 month + clinically significant distress/impairment
Use casePayer/billing, epidemiologyAssessment, treatment formulation

See APA DSM-5 and NIMH: PTSD.

Documentation examples you can adapt

Therapy progress note (excerpt)

Dx: F43.12 (PTSD, chronic)  |  PCL-5: 46
S/O: Client reports intrusive memories (daily), nightmares (3x/week), and avoidance of driving routes near crash site. Affect tearful; hypervigilance in office hallway.
A: PTSD chronic; impact on work attendance and driving. No SI/HI today. Good insight; engaged in skills practice.
P: Continue TF-CBT weekly; add written exposure hierarchy; track sleep via diary; ROI on file for PCP. Next review in 30 days.

Medication management note (excerpt)

Dx: F43.11 (PTSD, acute)  |  PCL-5: 34
S/O: Nightmares, startle response, irritability following assault 6 weeks ago. Tolerating sertraline 50 mg with mild GI upset.
A: Acute PTSD; partial response. No current safety concerns.
P: Titrate sertraline to 75 mg; reinforce CBT-I for sleep; follow-up 4 weeks; consider prazosin if nightmares persist.

For note structure, see our guides on SOAP notes, DAP notes, and progress notes.

Practical coding tips (reduce denials)

  1. Document duration clearly. If < 3 months, consider F43.11; if ≥ 3 months, F43.12. Update F43.10 once duration is known.
  2. Anchor to DSM-5 clusters. Note at least one intrusion, one avoidance, and mood/cognition + arousal symptoms with functional impact.
  3. Track outcomes. PCL-5, insomnia severity, avoidance frequency; add baseline and trend to support medical necessity.
  4. Pair ICD with the right CPT. Intake/med evals may use 99203/99204; psychotherapy 90832/90834/90837; add-on crisis codes when applicable.
  5. Clarify differentials. If symptoms are sub-threshold or stressor-linked, consider F43.2 adjustment disorder; for immediate, transient reactions, see F43.0.

Planning care? See treatment plans and discharge summaries.

PTSD ICD-10: frequently asked questions

What ICD-10 codes do I use for PTSD?
Use the F43.1x family: F43.10 (unspecified), F43.11 (acute, < 3 months), F43.12 (chronic, ≥ 3 months). Ensure documentation supports trauma exposure, symptom clusters, duration, and functional impact.
Is PTSD a billable diagnosis in outpatient therapy?
Yes. F43.10/11/12 are billable in therapy and psychiatry. Pair with appropriate CPT codes (e.g., 90834/90837; 99203 for new-patient med eval when criteria are met) and justify medical necessity with outcomes and functional impairment.
How do ICD-10 and DSM-5 differ for PTSD?
DSM-5 defines four symptom clusters (B–E) and requires distress/impairment > 1 month. ICD-10 provides the billing code structure (F43.1x) with acuity specifiers. Use DSM-5 to diagnose; code with ICD-10 for billing.
When should I use F43.0 or F43.2 instead?
Use F43.0 (acute stress reaction) for immediate, short-lived responses to trauma. Use F43.2x (adjustment disorders) when symptoms follow a stressor but don’t meet PTSD criteria.
What outcome tools support PTSD coding?
The PCL-5 (PTSD Checklist) is widely used. Also track sleep metrics, avoidance frequency, and functional outcomes (work, school, social).

Written by TherapyDial Editorial Team • Clinically reviewed for accuracy and payer compliance.

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