F43.8 — Prolonged Grief Disorder

Clinical Description

F43.8 is used to code prolonged grief disorder (PGD), which was added to the DSM-5-TR. PGD involves an intense grief response following the death of a close person, with symptoms persisting beyond expected cultural norms (at least 12 months for adults, 6 months for children) and causing significant functional impairment.

Key Symptoms to Document

When using F43.8, your documentation should reference these symptoms:

• Intense longing or yearning for the deceased
• Preoccupation with thoughts or memories of the deceased
• Identity disruption (e.g., feeling as though part of the self has died)
• Marked disbelief about the death
• Emotional numbness or difficulty experiencing positive emotions
• Avoidance of reminders that the person is dead

Common Interventions to Document

Evidence-based interventions typically documented with this diagnosis:

• Prolonged Grief Disorder Therapy (PGDT / Complicated Grief Treatment)
• CBT adapted for grief
• Supportive grief counseling
• Grief-focused group therapy
• Pharmacotherapy for co-occurring depression or insomnia if indicated

CPT Code Pairings

Common CPT codes used when billing with F43.8:

• 90791 — Psychiatric diagnostic evaluation
• 90837 — Individual psychotherapy, 60 minutes
• 90834 — Individual psychotherapy, 45 minutes
• 90853 — Group psychotherapy
• 96127 — Brief emotional/behavioral assessment

Documentation Tips

• Document the death of a close person and the relationship to the deceased.
• Record duration of grief symptoms — must persist at least 12 months for adults (6 months for children/adolescents) after the death.
• Note that grief intensity is beyond expected cultural, religious, or age-appropriate norms.
• Document at least 3 of 8 additional symptoms: identity disruption, disbelief, avoidance, intense emotional pain, difficulty reintegrating, emotional numbness, meaninglessness, intense loneliness.
• Differentiate from normal grief by documenting clinically significant distress or functional impairment that persists well beyond the expected mourning period.

Differential Diagnosis Considerations

When documenting F43.8, consider and rule out:

• Normal bereavement (Z63.4)
• Major depressive disorder (F32.x / F33.x)
• Post-traumatic stress disorder (F43.10)
• Adjustment disorder with depressed mood (F43.21)
• Separation anxiety disorder (F93.0)

Screening Tools

Standardized measures commonly used with this diagnosis:

• PG-13 (Prolonged Grief Disorder scale)
• ICG (Inventory of Complicated Grief)
• Brief Grief Questionnaire (BGQ)
• PHQ-9 (to screen for comorbid depression)
• TRIG (Texas Revised Inventory of Grief)