CPT 90791 + ICD-10 F94.2: Disinhibited social engagement disorder
Psychiatric diagnostic evaluation billed with Disinhibited social engagement disorder — documentation requirements, denial reasons, modifiers, and reimbursement context.
CPT Code
90791
Psychiatric diagnostic evaluation
ICD-10 Code
F94.2
Disinhibited social engagement disorder
Compatibility Notes
Initial evaluation for a child presenting with DSED. This is an uncommon billing code outside of early childhood specialty settings. The evaluation must document history of social neglect or institutional care and current disinhibited social behaviors. F94.2 is a childhood-onset diagnosis; adult use is not appropriate.
Documentation Required
- ✓Comprehensive developmental history including institutional or neglectful care history
- ✓DSED criteria documented (disinhibited social approach to strangers)
- ✓Child age and developmental level
- ✓Differentiation from RAD (the two can co-occur)
- ✓Caregiver-inclusive treatment plan
Common Denial Reasons
- ✗Adult patient coded with childhood-onset diagnosis
- ✗No history of pathogenic care documented
- ✗DSED and RAD conflated without clinical differentiation
Applicable Modifiers
Reimbursement Notes
OON UCR $175–$350. DSED evaluations are rare in standard outpatient practice; early childhood specialist credentials support claims.
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