Guide to the F94.0 Code for Selective Mutism

In the late 19th century, the International Classification of Diseases was formed to ensure that any diagnosis a doctor makes comes with a code. This code makes it easy for doctors to identify the symptoms and potential treatments of any condition. 

Once individuals receive a diagnosis, the ICD-10 code attached to it will be placed on any medication they’re prescribed. The ICD document has been revised numerous times. While the ICD-10 revision began in 1999, it wasn’t fully implemented by the U.S. until 2015. The F94.0 code stands for selective mutism, which is an anxiety disorder that tends to develop in children. In this guide, you’ll learn about the F94.0 code and what it means.

Why ICD-10 Codes Are Used

ICD-10 medical codes provide physicians and doctors with the ability to label any diagnosis they make. Over time, revisions are made to the ICD to match the changes that have occurred in the medical field. ICD-9 has been used by healthcare professionals for decades. In the latter years, it was no longer capable of meeting healthcare needs. 

ICD-10 has been put in place throughout the world because it delivers a common language that many countries can turn to for monitoring, recording, and reporting diseases. Medical professionals can use these codes to share and compare their data in an easy-to-understand manner. These codes are currently used by nurses, physicians, researchers, insurers, and policymakers. ICD-10 code sets provide data for:

  • Making clinical decisions
  • Processing claims and designing payment systems
  • Identifying instances of fraud
  • Improving data for epidemiological research
  • Tracking various public health conditions
  • Measuring care outcomes

What Is the F94.0 Code?

The F94.0 code is an ICD-10-CM code that’s used to signify selective mutism. The most up-to-date version of this code excludes specific disorders from this label, which extends to the following:

  • Schizophrenia
  • Pervasive developmental disorders
  • Certain developmental disorders of language and speech
  • Transient mutism

Selective mutism refers to a consistent inability to speak in specific social situations when doing so is expected. The affected individual can speak in many other situations but can’t do so in school or when meeting new people. This is considered a behavioral and developmental disorder.

What Does Selective Mutism Involve?

Selective mutism is a rare condition that always begins during childhood. It also displays itself differently depending on the child. Some children may be fine with speaking at school but unable to do so when they’re meeting with relatives they haven’t seen for a while. However, the condition most often causes problems at school. 

When a child has selective mutism, they may find that some social situations are highly stressful. The stress and anxiety can get so severe that they feel like they can’t speak. Keep in mind, however, that this condition doesn’t occur because a child chooses not to speak. It’s possible for children who develop this condition to have other tangible speech problems. 

Causes of Selective Mutism

Currently, there is no specific cause of selective mutism. There are, however, numerous factors that increase the risk of developing this condition, which include the following:

  • Self-esteem issues
  • Anxiety disorders
  • Bad family relationships
  • Difficulty with sound processing
  • Language or speech problems
  • Untreated psychological problems
  • A traumatic experience
  • Family history of any anxiety disorder

Selective mutism is widely viewed as a phobia that children can have of talking to specific people. The child might otherwise show a tendency to become anxious in relatively normal situations. If children with selective mutism also suffer from a hearing problem or language issue, they might find it more challenging to speak. 

Children can also have a problem with processing loud noises or other sensory information, which is referred to as sensory integration dysfunction. In this scenario, the affected child can “shut down,” which is when selective mutism occurs. 

There are times when mutism is a symptom associated with post-traumatic stress. The specific form of selective mutism is much different than the other types. When it’s derived from post-traumatic stress, children might stop talking in places where they were previously able to speak. Though selective mutism is often believed to be associated with autism, there isn’t a link between the two conditions. 

Signs and Symptoms of Selective Mutism

While selective mutism can occur at all ages, it tends to develop among children who are between the ages of two to four. It might initially appear when children are taken to school or a nursery for the first time. Along with being unable to speak, affected children might become very still. The main symptoms of this condition include the following:

  • Clingy
  • Shy
  • Sulky and rude
  • Nervous and socially awkward
  • Having temper tantrums after school
  • Being aggressive or stubborn

Some children with selective mutism can be confident, which might allow them to respond to others with a head shake or nod. Children with a severe form of the condition might be unable to make any kind of gestured or spoken communication. 

How Selective Mutism Is Diagnosed

If selective mutism is left untreated, it can result in low self-esteem, social anxiety disorder, and isolation. In this scenario, the condition won’t dissipate after childhood. It can continue into a person’s teenage years and adulthood. A child who suffers from selective mutism can learn to overcome it if they receive a diagnosis when they are still young. A proper diagnosis means that treatment should be provided. 

While treatment often involves different forms of therapy, it can also occur in other ways. For example, children’s parents can work with the school to lower their anxiety. Staff members can learn how to provide the necessary support. Children who experience this condition might need to see a school educational psychologist or mental health professional. 

During the process of making a diagnosis, the psychologist or mental health professional might ask about the child’s family’s history of anxiety disorders. Questions can also revolve around the causes of anxiety and any behavioral characteristics associated with heightened stress. Children with selective autism might be incapable of speaking throughout the assessment. Instead, they may be encouraged to communicate through their parents or via a computer. 

It’s not always easy for parents to identify that their child is suffering from selective mutism. They might believe it to be a general shyness that the child will grow out of. In this case, the child may not receive a diagnosis until adulthood. An adult can also overcome selective mutism. However, the psychological effects associated with not having many social interactions over the years may linger. Adults can receive help from a mental health professional or speech and language therapist. 

Potential Treatment Options

The duration of treatment for selective mutism mainly depends on the severity of the condition and when the treatment is provided. Treatment usually takes longer for teenagers and adults. The efficacy of any treatment for this condition depends on the client’s cooperation and the presence of any other anxieties or learning difficulties. 

Keep in mind that treatment doesn’t center around helping children learn how to speak in stressful situations. Instead, it aims to reduce the anxiety that they feel when trying to speak. In most cases, it involves removing the pressure that the person must speak. The end goal of this treatment is to help the affected person speak without issue to anyone in any setting. 

Individual Therapies

There are numerous therapies that a child or adult can receive to treat a case of selective mutism. For example, cognitive behavioral therapy is designed to help individuals learn what they currently think about other people and themselves. The purpose of this therapy is to challenge the person’s preconceptions and fears. 

Clients can also receive behavioral therapy, which centers around going through a slow, step-by-step process to challenge and conquer fear. Keep in mind that there are many different forms of behavioral therapy, some of which can also be administered by family members when the child isn’t in therapy. 

One type of cognitive behavioral therapy is graded exposure, which involves focusing first on the situations that cause the least amount of anxiety. With repeated exposure to these situations, the anxiety should become manageable. Adolescents and adults who receive this therapy are usually asked about their experiences to determine how anxious they feel during different situations. 

People with selective mutism can also benefit from stimulus fading. This form of behavioral therapy involves the affected person communicating with someone they are comfortable with in a one-on-one conversation. Over time, more people are introduced to the situation. A couple of additional types of behavioral therapy that might be administered include shaping and desensitization.


Medicine can be prescribed to adolescents and adults who suffer from selective mutism. However, it’s mainly used after behavioral methods and environmental changes have been implemented. Antidepressants might also be prescribed to lower anxiety levels.

Why Medical Codes Are Important

Accurate ICD-10 codes are highly important when diagnosing and treating clients. When doctors diagnose someone, they can use the code that’s attached to the specific condition to identify potential treatments and help clients learn more about their condition. With this information in hand, doctors can provide better quality care. The implementation of ICD-10 codes has the following advantages:

  • Codes are more detailed
  • Injuries and poisonings have much more information
  • New concepts like alcohol level and blood type are available
  • Postoperative codes have been expanded considerably

There are thousands of diagnoses for diseases, injuries, and illnesses that a doctor or physician can make. ICD-10 codes are essential for making sure that doctors and other medical professionals have everything they need to track illnesses and provide better care. 

Medical professionals can also improve the quality of care they provide with AutoNotes, which is an advanced AI progress notes tool that assists in the production of treatment plans, DAP notes, and SOAP notes. These tools are beneficial for healthcare providers and their clients. The AutoNotes platform is dedicated to clinicians and iterates based almost entirely on user metrics and feedback.