Separation Anxiety Disorder of Childhood ICD-10 Code

As a healthcare professional, you use ICD-10 codes every day. This abbreviation stands for International Classification of Diseases, which is in its 10th edition. If you work with children, you need to know more about the code for separation anxiety disorder of childhood. Though kids of all ages experience some form of separation anxiety, the disorder can be serious and affect their lives in various ways. Prepare your practice, and get ready for an appointment with a detailed look at the disorder, its ICD-10 code, and why you need to use it.

What Is Separation Anxiety Disorder of Childhood?

As kids grow, they go through several stages of development. Babies and toddlers usually spend a lot of time with their families and follow a set routine, which makes it difficult for them when their lives go through changes. Separation anxiety occurs when they experience a routine change that takes them away from their homes and families. When a child still shows signs of anxiety later in life, they may have a separation anxiety disorder. It should stop around the age of 3 but can persist into the teen years and even adulthood.

Symptoms and Signs

As a physician who works with children, you can observe the signs of the disorder in younger clients. The main symptoms of childhood separation anxiety include:

  • Refusal to spend the night without one or both parents
  • Visible distress when they’re away from their families
  • Bad dreams that relate to a perceived separation
  • Persistent and anxious thoughts, especially about losing their loved ones
  • Inability to leave their parents or their homes because of what they fear might happen
  • Inability to be alone, even in familiar places

In some cases, the child may also present with physical symptoms. They may complain that they’re sick or their head and/or stomach hurts. Some kids actually experience those issues when they need to be away from their parents. Other children just claim they have symptoms, hoping their parents will stay with them.

Children form attachments to the adults in their lives and others who are around them. Separation anxiety disorder in childhood, also known as SAD, causes kids to worry and feel anxious when they’re away from those individuals or when they might be away from them. Symptoms can appear when the child goes to school or any other location as well as when the parent goes to work or the store without them.

Who Does SAD Affect?

Over 4% of children experience some form of SAD, but research indicates that it affects girls more than boys. Around 13% of all kids between ages 9 and 17 have some form of anxiety, but only a small number suffer from SAD. Doctors usually use the ICD-10 code for separation anxiety disorder of childhood if the child shows signs at a younger age. Many kids receive a diagnosis before they begin school or preschool.

Causes of SAD

Both parents and doctors want to know what causes SAD. A common cause is some type of event where the child experiences trauma or stress. One example is an illness or injury. If the child spends a long period of time in the hospital, they may develop SAD because they think they are going back to the hospital every time they leave it. A hospital stay can also make them feel anxious as they remember the time they were away from home. SAD also affects children who lost someone they care about or moved to a new school or home. 

Other possible causes of SAD include:

  • Serious attachment to loved ones
  • One or more overprotective parents or adults
  • Other disorders, such as obsessive-compulsive disorder (OCD) or agoraphobia
  • Parent(s) with separation anxiety

How SAD Affects Kids

If you see the ICD-10 code for SAD in a client’s chart, you may assume that they just don’t like being away from their parents. The condition can cause many different issues in the child’s life. Kids can call home multiple times when they’re away from school or at a friend’s house. They are unable to get through the day or just a few hours without checking in to ensure things are OK. Some kids even fake being sick to stay home and keep their parents at home, leading to more appointments with their doctors.

The Child Mind Institute found that SAD can lead to overattachment. This is when the child goes to great lengths to stay close to one or more adults. They may refuse to sleep unless they can be in the same bed and may even crawl into someone’s bed while they sleep. The disorder may cause the child to follow the person around the house most of the time and act anxious when they’re left alone, even if the parent just needs to take a phone call or use the bathroom.

ICD-10 Code for Separation Anxiety Disorder of Childhood

An ICD-10 code serves as the primary diagnosis code used in a client’s file. It lets you and any other healthcare provider who sees the child know that they have an official diagnosis. This code falls between those used for conduct disorders and other types of emotional disorders. The ICD-10 code is F93.0. Though the child may suffer from other conditions or disorders, SAD is often the primary condition.

Diagnosing SAD in Children

You cannot add this code to a child’s file until you diagnose them. Separation anxiety is a normal part of childhood. Babies often seem confused when they experience new people and places. Later in their toddler years, they learn that those experiences aren’t scary. Even if their mom or dad leaves in the morning, they know the parent will return later. However, kids with SAD never form those connections. 

Diagnosing a child with SAD requires that you look for a combination of symptoms and how they act around their parents. It’s often helpful to ask the parent to leave the room for a few minutes to judge how the child reacts. A child with SAD will exhibit signs of distress. They may ask where the person went, refuse to talk to you, or even try to leave the room. Their actions will help you determine if they have SAD, which allows you to talk with the parent and decide how to treat the client. You cannot diagnose a client with SAD unless they have experienced symptoms for four weeks or longer and have problems functioning because of their symptoms.

The functioning problems can include:

  • Trouble spending a full day at school and away from home
  • Refusing to spend the night at a friend’s house
  • Acting out in school in hopes of going home
  • Playing sick to avoid going to school
  • Crying or acting out when the parent tries to do things without them

SAD Treatment in Children

Though the treatments for separation anxiety disorder of childhood are similar to the treatments for adults, they focus more on helping the child develop stronger social skills to ease their anxiety. One common treatment is psychotherapy or talk therapy. Psychotherapy gives the child a safe place to talk about their anxiety or stress. In general, around 75% of psychotherapy clients of all ages benefit from their sessions. Each session lasts up to 50 minutes. The child may attend therapy for a few months or much longer.

Cognitive behavioral therapy (CBT) is one of the top types of psychotherapy. It helps the child learn how to change the way they think about being away from their loved ones. They might learn how to focus on the benefits of attending school or being with their friends, such as how much fun they can have or what they will learn. 

Other treatment options for kids include interaction therapy, which focuses on the child, their parents, or their bravery. Child-directed interaction makes the child feel safe and involves the parent giving them attention away from home. This helps the client realize that they will get support anywhere they go. Parent-directed interaction puts the adult in control. They learn what to do when the child acts out and how to handle tantrums and other issues. 

With bravery-directed interaction, the child takes small steps to get control over their feelings. They get a ladder marked with different scenarios or situations. The child lists different activities that make them feel anxious with the least anxious scenarios on the bottom and the worst at the top. For example, they may worry when their mom leaves the room or leaves the house to check on the mail but feel worse when they go to school or the parent goes out with friends. The child receives rewards as they work their way up the ladder and conquer each situation.

Why Use ICD-10 Codes for Kids?

It wasn’t that long ago that physicians used different terms and types of language to describe disorders and conditions. This led to confusion as clients moved to new doctors and treatment centers. One of the benefits of using ICD-10 codes is that doctors around the world use the same codes, which clears up any confusion. The codes are available in more than 40 languages, including those used in North America. When you see F93.0 in a new client’s file, you know they have a diagnosis of separation anxiety disorder of childhood.

This is important because a child with SAD may have a hard time opening up to a new doctor. They might refuse to speak to you unless a parent is in the room or keep trying to run out as you perform tests. Knowing the diagnosis helps you take steps to keep them comfortable. This might require that you let the parent stay close by or that you make arrangements to have the parent sit in during any required tests.

Another thing to keep in mind is that you may run tests you don’t need to run when you see a new juvenile client. Kids will separation anxiety disorder often experience both phantom and physical symptoms. You may not need to run a battery of tests when they have a headache because you know it’s a symptom of SAD. Knowing the symptoms a client has usually helps you quickly identify new ones and find ways to treat any symptoms they have not connected to the disorder.

This also helps you coordinate with other providers, especially those involved in the client’s treatment. If you are the child’s primary care physician, you can work with their psychologist or psychotherapist. The code also helps you compare and share notes to see any new symptoms the child has, which might require a new diagnosis. Using the current ICD-10 code also helps you bill the client’s insurer for any treatment you provide. 

Knowing that F93.0 is the right ICD-10 code ensures you provide an updated diagnosis, too. ICD-9 codes were common for many years and only ended in 2015. The old code marked just a few symptoms of separation anxiety disorder in childhood, such as developmental delays and some type of distress. Doctors now know that the disorder can present with other symptoms that include physical signs. The new code shows you that other signs may indicate the child has SAD.

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