F90.2 ICD-10 Code: ADHD, Combined Type

F90.2 at a glance

ADHD combined type ICD-10: what F90.2 means

Combined type is the presentation where a client shows both clusters of ADHD symptoms: trouble sustaining attention and organizing, and also restlessness, blurting out or acting before thinking. In the Alphabetic Index, "Disorder, attention‑deficit hyperactivity, combined" leads to F90.2 whether the note says "presentation" or "type". The older ICD‑10‑CM wording and the DSM‑5‑TR wording land on the same code.

It's also the code most often reached by default when a clinician writes "ADHD" and means the classic picture of a child who is both distractible and constantly on the move. That shortcut doesn't work. A diagnosis line of plain ADHD indexes to F90.9, so the presentation has to be written out for the claim to show F90.2.

F90.2 vs F90.0, F90.1 and F90.9

The four codes describe the same disorder at different levels of detail. What decides between them is which symptom clusters the latest evaluation found at the diagnostic level.

More on the neighbors: F90.0 for the inattentive type and F90.9 for ADHD with the type left out. Kids often move between presentations as they grow. A 7‑year‑old coded F90.2 may meet only the inattentive criteria at 14, once the motor restlessness has faded, and the claim should follow the newer evaluation.

F90.2 with oppositional defiant disorder or conduct problems

This is the question that comes up most in child and family work. Category F91, conduct disorders, carries an Excludes2 note for "conduct problems associated with attention‑deficit hyperactivity disorder (F90.‑)". Under the Official Guidelines, an Excludes2 note means the excluded condition isn't part of the code, but a patient can have both.

In practice that gives you two cases. Arguing, rule‑breaking and outbursts that you see as part of the ADHD stay inside F90.2, with nothing added. When you diagnose oppositional defiant disorder as its own condition, F91.3 goes on the claim next to F90.2. The note has to show which case it is: a separate ODD diagnosis needs its own symptom description, and a line saying the child is defiant won't carry it.

Anxiety, depression and autism follow the same Excludes2 logic from the F90 side, so codes such as F41.1 or F84.0 can be reported with F90.2 when each is diagnosed. A child with ADHD and developmental coordination disorder can also carry F82; neither code has an exclusion note against the other.

Don't add symptom codes for impulsiveness or restlessness

R45.87 (impulsiveness) and R45.1 (restlessness and agitation) are real, billable codes, and it's tempting to add them when a note is full of those words. Section I.B.5 of the FY2027 Official Guidelines says signs and symptoms that are routinely part of a disease process shouldn't be coded in addition. Impulsivity and restlessness are the hyperactive half of combined type, so with F90.2 on the claim they add nothing.

What to document for F90.2

• Inattentive and hyperactive-impulsive symptoms listed separately, each with examples from at least two settings.
• Who reported them: parent, teacher, partner or the client, and the rating scales used with their dates.
• When the symptoms started and how they affect school, work or home.
• Whether you diagnosed a co-occurring disorder such as ODD, anxiety or a learning disorder, or judged the behavior part of the ADHD.
• The date of the evaluation the presentation comes from, so a later reviewer can see it's current.

Example, fictional client. 8‑year‑old boy, follow‑up after evaluation. Mother and second‑grade teacher both rate inattention and hyperactivity in the clinical range on standardized forms completed this month. At home he leaves homework half done and loses his shoes most mornings; at school he leaves his seat during lessons and answers before the question is finished. Argues at bedtime, but mother reports no pattern of spite or deliberate defiance, and teacher reports none at school; not meeting criteria for ODD. Diagnosis: ADHD, combined presentation (F90.2). Plan: parent behavior training sessions every two weeks, teacher daily report card, psychiatry referral for medication evaluation.

For tracking change between visits, the ADHD symptom tracker gives parents and teachers one shared form, and the family therapy note template suits the parent training sessions.

CPT codes billed with F90.2

Code pages: 90791, 90792, 96127, 90846, 90847, 90837, 99214 and 90833.

CPT is a registered trademark of the American Medical Association. CPT codes copyright 2026 American Medical Association. All rights reserved.

Common mistakes with F90.2

• Writing only "ADHD" in the diagnosis line. It codes to F90.9. Name the combined presentation.
• Keeping F90.2 after a reassessment finds only inattentive symptoms. Teenagers and adults often shift to F90.0.
• Adding F91.3 for defiance that is part of the ADHD. ODD goes on the claim only when you diagnosed it separately.
• Adding R45.87 or R45.1. Impulsiveness and restlessness are integral to combined type.
• A parent session note that never mentions the child. When 90846 is billed under the child's F90.2, the note should say what was worked on for the child's symptoms.

If an AI scribe drafts the note, check that the presentation it wrote matches your evaluation. Twofold's AI therapy notes keep the diagnosis line editable before you sign.

Checked against the FY2027 ICD‑10‑CM code set and Official Guidelines from CMS on October 19, 2026. F90.2 and category F90 did not change this year.