F90.0 — ADHD, Predominantly Inattentive

Clinical Description

F90.0 codes ADHD predominantly inattentive presentation, where inattention symptoms predominate without significant hyperactivity or impulsivity. Documentation must establish symptom onset before age 12, presence in two or more settings, and impact on functioning.

Key Symptoms to Document

When using F90.0, your documentation should reference these symptoms:

• Difficulty sustaining attention in tasks or play activities
• Frequent careless mistakes in work or other activities
• Difficulty organizing tasks and managing time
• Avoidance of tasks requiring sustained mental effort
• Frequently losing items necessary for tasks
• Easily distracted by extraneous stimuli or unrelated thoughts

Common Interventions to Document

Evidence-based interventions typically documented with this diagnosis:

• Stimulant medication (methylphenidate, amphetamine-based)
• Non-stimulant medication (atomoxetine, guanfacine, viloxazine)
• CBT for ADHD focusing on executive function skills
• Organizational skills training and time management coaching
• Psychoeducation for patient and family

CPT Code Pairings

Common CPT codes used when billing with F90.0:

• 90791 — Psychiatric diagnostic evaluation
• 96136 — Psychological/neuropsychological testing (first 30 min)
• 96137 — Psychological/neuropsychological testing (each additional 30 min)
• 99214 — Office visit, moderate complexity (medication management)
• 96127 — Brief emotional/behavioral assessment

Documentation Tips

• Document at least 6 inattentive symptoms (5 for adults age 17+) with specific behavioral examples.
• Establish symptom onset before age 12, even if diagnosis occurs in adulthood — collateral history may be needed.
• Record evidence of symptoms in at least 2 settings (e.g., school/work and home).
• Document that symptoms are not better explained by another mental disorder (anxiety, mood disorder, dissociative disorder).
• Include objective measures such as rating scales completed by multiple informants (self, parent, teacher/supervisor).

Differential Diagnosis Considerations

When documenting F90.0, consider and rule out:

• Generalized anxiety disorder (F41.1)
• Major depressive disorder (F32.x / F33.x)
• Specific learning disorder (F81.x)
• Autism spectrum disorder (F84.0)
• Sleep disorders causing inattention
• Substance use disorders

Screening Tools

Standardized measures commonly used with this diagnosis:

• ASRS v1.1 (Adult ADHD Self-Report Scale)
• Vanderbilt ADHD Diagnostic Rating Scale (pediatric)
• Conners Adult ADHD Rating Scale (CAARS)
• SNAP-IV (Swanson, Nolan, and Pelham Rating Scale)
• WFIRS (Weiss Functional Impairment Rating Scale)