Agitation ICD-10-CM Codes | 2023

What ICD-10 Codes are Used for Agitation?

Agitation is a complex clinical symptom characterized by feelings of restlessness, increased tension, and unease. It can manifest in various ways, from verbal outbursts to physical aggression, and can indicate underlying medical or psychiatric conditions. 

Given the multifaceted nature of agitation, it's imperative to have precise coding for accurate clinical documentation and billing. The ICD-10 system offers specific codes to classify and bill for this symptom. Here's an expanded look at the ICD-10 codes predominantly used for agitation:

• R45.1 - Restlessness and agitation: This foundational code is designed to capture the essence of agitation. It addresses the general feelings of restlessness and unease without delving into the root cause or associated conditions.
• F03.A11 - Dementia with behavioral disturbance, with agitation: Behavioral disturbances can often accompany dementia. This code is specifically tailored for patients with dementia who exhibit signs of agitation, highlighting the cognitive aspect of their condition.
• R45.4 - Irritability and anger: While this code doesn't exclusively denote agitation, it's crucial for capturing those patients who primarily present with heightened irritability and anger, which can be precursors or components of agitation.
• R45.5 - Hostility: Hostility can be a manifestation of deeper psychological or physiological issues. This code is essential for documenting instances where hostility is the dominant symptom, which can sometimes overlap with or be misinterpreted as agitation.
• R45.6 - Physical and verbal aggressive behavior: Agitation can sometimes escalate to aggressive behavior. This code is reserved for patients who display physical and verbal aggression, indicating a heightened state of agitation.
• R45.7 - State of emotional shock and stress, unspecified: Emotional shock or acute stress can induce symptoms of agitation. This code is used for those scenarios where a patient's agitation is potentially linked to recent traumatic or stressful events.

For healthcare professionals and billing specialists aiming to deepen their understanding of the nuances of medical billing and coding, especially concerning agitation and its related conditions, our Agitation ICD Codes serve as a comprehensive resource, shedding light on the intricacies of this challenging symptom.

Which Agitation ICD codes are Billable?

• R45.1 - Yes
• F03.A11 - Yes
• R45.4 - Yes
• R45.5 - Yes
• R45.6 - Yes
• R45.7 - Yes

Clinical Information

Agitation, while commonly perceived as mere restlessness or irritability, is a multifaceted symptom indicative of deeper underlying conditions. Its manifestations can range from mild unease to severe distress, and understanding its root causes and presentations is crucial for effective management. 

Here's a more detailed exploration of its clinical aspects:

Varied Manifestations

Agitation can present in numerous ways, from verbal outbursts and excessive talking to physical restlessness and aggressive behavior. The intensity and type of manifestation can offer clues about its underlying cause.

Underlying Conditions

Agitation isn't just a standalone symptom. It can indicate various underlying conditions, including psychiatric disorders like bipolar or schizophrenia, neurocognitive conditions like dementia, or even metabolic imbalances and infections.

Drug-Induced Agitation

Certain substances, whether recreational or medicinal, can induce or exacerbate agitation. This includes intoxication from drugs like stimulants, withdrawal from substances like alcohol, or side effects from certain antipsychotics or steroids.

Comprehensive Management

Addressing agitation isn't just about calming the patient in the moment. It requires a holistic approach that includes identifying and treating the root cause, be it a medical condition, a psychiatric disorder, or an external factor like drug use.

Non-Pharmacological Interventions

While medications can be used to manage severe agitation, non-pharmacological interventions are often the first line of treatment. This can include calming techniques, cognitive-behavioral therapy, or environmental modifications to reduce stimuli causing distress.

Importance of Early Intervention

Recognizing and addressing agitation early can prevent its escalation, reducing the risk of harm to the patient or others and facilitating more effective management and treatment.

Synonyms Include:

• Restlessness
• Unease
• Tension
• Excitability
• Nervousness