Understanding ICD-10 Code F68.10: Factitious Disorder

The International Classification of Diseases (ICD) is a global system that provides a uniform classification of diseases and psychological conditions for tracking purposes. It is also important for insurance billing. Factitious disorder is covered by section 69 of the ICD-10 codes. Understanding these codes will help you bill properly and provide a better quality of care for your client. 

Understanding the ICD-10 F68 Code Category

Factitious disorder is a condition where a person engages in deceiving others by taking measures to appear to have a psychological or physical condition that they do not. They might also take steps to become ill on purpose or cause self-injury. 

Section F68 also includes those who try to make others appear to be ill, such as a child having cancer. It is a complex condition that can place the person or the target of their condition in danger. Proper ICD-10 coding is important for getting the person prompt, quality care. 

The ICD-10 codes for factitious disorder include simple unspecified factitious disorder (F68.10). This code is used when the condition is unknown at the time of coding. Further diagnostics and assessment might reveal further details at a later time. This is also a code that can be used by a generalist clinician who is not a specialist in that condition. Referral to a specialist might lead to a more specific code. 

Once it has been established that factitious disorder is present, the codes break the condition into those that display psychological signs and symptoms (F68.11), physical symptoms (F68.12), and those that display both psychological and physical symptoms (F68 13). These codes are used for those who have a factitious disorder imposed on themselves. For instance, they may pretend to have cancer in order to gain sympathy. 

In this section of ICD-10 codes, F68.8 stands out because it is not specifically for factitious disorder. This code is for “other specified disorders of adult personality and behavior.” This is not to be confused by conditions listed in section F60, which lists the following conditions:

  • Paranoid personality disorder
  • Schizoid personality disorder 
  • Antisocial personality disorder
  • Borderline personality disorder 
  • Histrionic personality disorder
  • Obsessive-compulsive disorder
  • Avoidant personality disorder
  • Dependent personality disorder
  • Narcissistic personality disorder 
  • Other specific personality disorder

One possible point of confusion might be when to use F68.8 and when to use a code from F60. One feature of personality disorders listed in F60 is that they are a lifelong pattern of behavior. F68.8 would be more suitable for a condition that represents a personality change that leans toward other listed and unspecified personality disorders. The personality change must cause some type of difficulty at work or in social situations. If you have any questions about which code is correct for a specific client, it is always best to contact the insurance company for clarification. 

The ICD-10 code F68.A is for factitious disorder imposed on another. This might include trying to gain sympathy by pretending a child or other loved one has a disease when they do not in actuality. Or instances may include hurting your child – breaking an arm, for example – and then rushing to the hospital in order to gain sympathy and seek attention.

Factitious Disease Symptoms

Factitious disease is when people pretend to have a disorder they do not have. They might make up symptoms, tamper with medical tests, or try to convince medical professionals to perform a risky procedure. They will try to convince others that they need some type of medication or dangerous surgery. This differs from making up symptoms for a specific purpose, such as winning an automobile accident lawsuit or feigning illness to get out of work. 

At first glance, this condition might appear to be of little consequence, but if not treated, it can lead to serious self-harm or even death. They might exaggerate symptoms to make it appear like a serious disease. People with this disease will go to extremes to hide their deception, and it can be difficult even for medical professionals to detect it. Sometimes, they do not receive any obvious benefit for their ruse. 

A few signs that a client might be trying to use deception to appear to have a condition include: 

  • Inconsistent symptoms that change over time
  • Extensive knowledge and use of medical terms about the disease
  • Conditions that suddenly worsen with no apparent cause
  • Standard therapies fail to help
  • Switching doctors frequently
  • Giving a fake practitioner or hospital name for previous treatment 
  • Not allowing you to contact other professionals or family members
  • Frequent testing, hospital stays, and risky procedures
  • Many surgical scars
  • Few visitors when hospitalized
  • Argumentative with care professionals 

In its more severe forms, factitious disorder is sometimes referred to as Munchausen Syndrome. When the person pretends that someone else is ill, it is called Munchausen by proxy. When the syndrome includes harm to a child, it can be a serious form of abuse that can place the child in extreme danger. Unnecessary medical care can have serious or life-threatening consequences. 

Factitious Disease Diagnosis

Diagnosing a factitious disorder can be challenging because it could be that the person simply has a condition that has been misdiagnosed or ignored by clinicians. The symptoms listed above are only guidelines and details you might want to watch for, but it must be noted that a client can have legitimate reasons for displaying one or more of these symptoms. Diagnosis can take some research, like contacting other professionals about the client and making investigative inquiries. 

People with factitious disorders might exaggerate symptoms and make them appear more serious than is supported by medical evidence. They might make up a false medical history and might even go as far as falsifying medical records to support their claims. The person might fake symptoms, like seizures or pain. You also might suspect factitious disorder if the person suddenly worsens after negative test results, but you must rule out other conditions that could cause similar symptoms. 

Some of the more serious cases might involve taking measures to make themselves sick. For instance, they might take medications that they do not need, such as diabetes medication, blood thinners, or heart medications. They might inject themselves with milk, cleaning products, gasoline, feces, or other substances. 

The person might intentionally cut themselves or cause burns then interfere with healing by continually opening the wound. The person might tamper with lab results, like cutting themselves so the technician will find blood in a urine sample. These are only a few examples of the extreme measures that clients have taken to fake a medical condition. 

People with factitious disorder may or may not be aware that something is wrong. They are unlikely to seek help, and it is usually another family member or practitioner who brings it to someone’s attention. A person with this condition might refuse psychiatric or psychological evaluation. 

Factitious Disease Treatment and Prognosis

It is believed that about 1% of all hospitalizations are due to factitious disorder, but the actual numbers are not known. Of course, the first step in treating the condition is convincing the person that they need help. Unfortunately, many never reach this important realization until something tragic happens. 

When a person does seek help, the first goal is to change the person’s potentially harmful behaviors toward themself or others. The next goal is to uncover any underlying mental health conditions that might be a causal factor in the behaviors. These conditions are often treated using conventional psychiatric and psychological techniques. 

The most common treatment for this disorder is psychotherapy and counseling to change the person’s thinking and behaviors. Sometimes, family therapy is used to help other family members learn to recognize the behaviors and help them learn not to reinforce the behaviors. Medication is only used when it can help with an underlying condition. 

AutoNotes Makes ICD-10 Coding Easier

The ICD-10 code F68 is a complicated diagnostic code for many reasons. Seldom will people seek treatment on their own, and they can be quite skilled at the deception. It might be another member of the person’s care team that suggests this diagnosis. This is one diagnostic category in which taking good notes and keeping documentation is especially important. 

With factitious disorder, it is not only important to take good SOAP, DAP, treatment plans, and diagnostic notes for insurance purposes but also client care. You might have to work with other professionals who may or may not be aware of the deception. This means that your notes must be clear and concise. This not only assures timely compensation for services, but it could also help prevent people from further harming themselves. 

AutoNotes is an AI-driven software that makes taking diagnostic documentation fast and easy. It lets you have a single place to generate reports. These reports can easily be shared with other professionals and insurance providers. This allows professionals to communicate clearly and avoid confusion. 

AutoNotes is secure, encrypted, and HIPAA compliant, and it hides personally identifiable information. The software includes templates that help you make sure you have included everything in the report that is needed. It lets you summarize information from various formats and compile it into a single cohesive report. It also lets you download complete clinical notes from other professionals. 

AutoNotes saves you many hours spent on documentation and progress tracking. You can coordinate with other professionals more easily using this streamlined process. AutoNotes can save you hours every day spent writing and compiling notes. It also helps you get paid faster by making sure you meet insurance filing deadlines. Contact us to get started and see how AutoNotes can help you provide the best care for your clients.