F84.0 — Autism Spectrum Disorder

Clinical Description

F84.0 codes autism spectrum disorder (ASD), characterized by persistent deficits in social communication and social interaction, along with restricted, repetitive patterns of behavior, interests, or activities. Symptoms must be present in the early developmental period and cause clinically significant impairment.

Key Symptoms to Document

When using F84.0, your documentation should reference these symptoms:

• Deficits in social-emotional reciprocity (e.g., reduced sharing of interests, failure of back-and-forth conversation)
• Deficits in nonverbal communicative behaviors (e.g., limited eye contact, difficulty understanding gestures)
• Deficits in developing, maintaining, and understanding relationships
• Stereotyped or repetitive motor movements, speech, or use of objects
• Insistence on sameness, inflexible adherence to routines
• Hyper- or hypo-reactivity to sensory input or unusual sensory interests

Common Interventions to Document

Evidence-based interventions typically documented with this diagnosis:

• Applied Behavior Analysis (ABA) therapy
• Speech and language therapy
• Social skills training groups
• Occupational therapy for sensory integration
• CBT adapted for ASD (for co-occurring anxiety or depression)

CPT Code Pairings

Common CPT codes used when billing with F84.0:

• 90791 — Psychiatric diagnostic evaluation
• 96136 — Psychological/neuropsychological testing (first 30 min)
• 96137 — Psychological/neuropsychological testing (each additional 30 min)
• 97153 — Adaptive behavior treatment (ABA), each 15 min
• 90834 — Individual psychotherapy, 45 minutes

Documentation Tips

• Document deficits across all three areas of social communication AND at least two of four restricted/repetitive behavior categories.
• Specify the severity level for each domain: Level 1 (requiring support), Level 2 (requiring substantial support), Level 3 (requiring very substantial support).
• Note that symptoms must be present in the early developmental period, even if recognized later in life.
• Record whether ASD occurs with or without intellectual impairment and with or without language impairment.
• Document any known associated conditions (genetic syndromes, epilepsy, co-occurring ADHD, anxiety).

Differential Diagnosis Considerations

When documenting F84.0, consider and rule out:

• Social (pragmatic) communication disorder (F80.82)
• Intellectual disability (F7x)
• ADHD (F90.x)
• Social anxiety disorder (F40.10)
• Selective mutism (F94.0)
• Schizoid personality disorder (F60.1)

Screening Tools

Standardized measures commonly used with this diagnosis:

• M-CHAT-R/F (Modified Checklist for Autism in Toddlers, Revised)
• ADOS-2 (Autism Diagnostic Observation Schedule)
• ADI-R (Autism Diagnostic Interview — Revised)
• SRS-2 (Social Responsiveness Scale)
• AQ (Autism Spectrum Quotient — for adults)