F90.2 — ADHD, Combined Type

Clinical Description

F90.2 represents the combined presentation of ADHD, in which both inattention and hyperactivity-impulsivity are prominent. 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:

• Trouble sustaining focus, with unfinished tasks and avoidable errors
• Disorganization: lost items, missed appointments, poor time management
• Physical or inner restlessness
• Impulsive decisions and talking over others
• Impact across home, school or work, and relationships

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. Code descriptions below are original plain-language summaries, not official AMA CPT descriptor text — consult a current CPT codebook for authoritative definitions:

• 90791 — Intake interview and diagnostic assessment
• 99214 — Established-patient medical visit, moderate-complexity decision-making (medication management)
• 90834 — Individual therapy, standard session (38–52 min)
• 96136 — Clinician's face-to-face time giving and scoring the tests (first 30 min)
• 96127 — Brief standardized symptom questionnaire, scored and documented

Documentation Tips

• Describe both the attention problems and the hyperactive-impulsive behaviors with concrete examples rather than counting symptoms; check the diagnosis against the DSM-5-TR.
• Provide specific examples of symptoms in each setting where they occur (home, work/school, social).
• Establish childhood onset 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