F90.2 — ADHD, Combined Type

Clinical Description

F90.2 represents the combined presentation of ADHD where both inattentive and hyperactive-impulsive symptom clusters meet the diagnostic threshold. This is the most commonly diagnosed presentation. Documentation must address symptoms from both domains.

Key Symptoms to Document

When using F90.2, your documentation should reference these symptoms:

• Difficulty sustaining attention and frequent careless mistakes
• Fidgeting, restlessness, and difficulty remaining seated
• Difficulty organizing tasks and following through on instructions
• Impulsive decision-making and difficulty waiting one's turn
• Frequently losing necessary items
• Excessive talking and interrupting others

Common Interventions to Document

Evidence-based interventions typically documented with this diagnosis:

• Stimulant medication (first-line pharmacotherapy)
• CBT for ADHD targeting executive function deficits
• Behavioral interventions and contingency management
• Non-stimulant medication (atomoxetine, guanfacine, viloxazine)
• Academic or workplace accommodations

CPT Code Pairings

Common CPT codes used when billing with F90.2:

• 90791 — Psychiatric diagnostic evaluation
• 99214 — Office visit, moderate complexity (medication management)
• 90834 — Individual psychotherapy, 45 minutes
• 96136 — Psychological/neuropsychological testing
• 96127 — Brief emotional/behavioral assessment

Documentation Tips

• Document at least 6 inattentive AND 6 hyperactive-impulsive symptoms (5 each for age 17+).
• Provide specific examples of symptoms in at least two settings (home, work/school, social).
• Establish childhood onset (prior to age 12) using developmental history or collateral information.
• Document that symptoms are not better accounted for by another disorder and cause clear functional impairment.
• Track treatment response using standardized rating scales at each visit.

Differential Diagnosis Considerations

When documenting F90.2, consider and rule out:

• ADHD, predominantly inattentive (F90.0)
• ADHD, predominantly hyperactive-impulsive (F90.1)
• Bipolar disorder (F31.x)
• Anxiety disorders (F41.x)
• Specific learning disorder (F81.x)
• 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
• Conners Adult ADHD Rating Scale (CAARS)
• WFIRS (Weiss Functional Impairment Rating Scale)
• Brown Attention-Deficit Disorder Scales