PFD ICD-10 FAQ
Will insurance companies acknowledge PFD as a diagnosis now that it has an ICD-10 code?
Yes, PFD will be acknowledged but coverage options will vary. Feeding Matters is advocating for recognition and reimbursement of PFD related claims as part of our broader Advocacy Agenda. However, reimbursement of any new code requires individual and collective advocacy and use of the code by the healthcare sector. Share the consensus paper with insurance companies, use the term PFD in clinical documentation, screen for PFD, and leverage a 4-domain assessment. By utilizing research driven tools such as the ICFQ© as a Screener Rack Card and the When to Refer Rack Card to screen and report fulfillment of diagnostic criteria when speaking with professionals and insurance providers, we promote PFD acknowledgement.
Will PFD be classified as a “psychological” disorder?
No, the diagnosis follows the criteria of the consensus paper and therefore encourages evaluation of all four domains, medical, nutrition, feeding skill and psychosocial, not solely psychosocial. Depending on your discipline you may focus on assessment and management within your primary domain and refer out to the other domains. PFD is often multi-faceted and evaluation of all domains is recommended.
Is PFD applicable to my NICU population?
Yes, PFD is applicable to children 0-17 years of age who fulfill the diagnostic criteria.
How do patients benefit from the PFD ICD code?
Having PFD referred to by name may bring comfort and validation to families. As PFD is used in assessment and management documentation and associated claims, we hope families are better able to access services in applicable domains and are able to receive coverage for such services.
Can professionals in the feeding skill domain (OTs and SLPs) “diagnose” PFD?
“Confusion regarding use of ICD codes is common. Feeding skill domain practitioners may assume they are solely medical diagnostic codes to be assigned by a practitioner within the medical domain. However, ICD-10 codes also serve as treating diagnosis codes and may be used by licensed practitioners, such as OTs and SLPs. Practitioners are encouraged to familiarize themselves with coding guidelines specific to their discipline.”
*excerpt taken from the Feeding Domain Fact Sheet in the Feeding Matters PFD & ICD-10 Toolkit
SLPs are encouraged to visit the ASHA Practice Portal for information at https://www.asha.org/practice/reimbursement/coding/new-and-revised-icd-10-cm-codes-for-slp/ . OTs can visit AOTA’s resource on coding and the ICD-10 at https://www.aota.org/Advocacy-Policy/Federal-Reg-Affairs/ICD-10-Diagnosis-Coding.aspx.
Now that PFD has an ICD-10 code do we capitalize “Pediatric Feeding Disorder”?
Diagnoses are not capitalized as they are common nouns verses proper nouns. While diagnoses named after a particular person, such as Alzheimer’s disease, are capitalized, the current recommendation is to use lowercase when referencing “pediatric feeding disorder” and PFD when using the acronym. Please visit https://apastyle.apa.org/style-grammar-guidelines/capitalization/diseases-disorders-therapies for more information on capitalization guidelines.
I want to present information on PFD and the ICD-10 code to other professionals. Will Feeding Matters offer a PowerPoint for downloading?
Yes, Feeding Matters is preparing a PowerPoint presentation for community education. This information will be shared during our December 2021 PFD Alliance Town Hall. Please join the Alliance to receive your invitation to attend this free interactive virtual education event once the exact date is finalized.
You also are encouraged to download the Entry-Level PFD PowerPoint and presenter script to start educating your community today. You can modify this nonbranded presentation to fit your education goals and share with any audience of your choosing, such as universities, medical teams, public health entities, clinics and community groups. Thank you for spreading the word about PFD.
Which countries can use the new ICD codes for PFD?
The ICD R codes for PFD are found in the United States ICD-10-CM update which goes into effect on October 1st, 2021. Other countries may be using a different version of the ICD for reimbursement and resource allocation or they may have already transitioned to the ICD-11 implementation version approved in 2019 at the World Health Assembly. Some countries do not use the ICD for such purposes and may use the ICD solely for tracking mortality statistics.
Each member state of the World Health Organization, determines if they will use the ICD for reimbursement and allocations purposes and whether and when they will update their ICD or convert to the ICD-11. You are encouraged to contact the government entities that regulate your country’s health care system to investigate if the ICD is being used and if so which version. Our hope is the PFD ICD-10 codes will be well utilized in the United States and integrated into other countries’ versions of the ICD.
My child has been diagnosed with ARFID. How does the new code for PFD apply to my child?
Feeding Matters acknowledges the confusion associated with the overlap between ARFID and pediatric feeding disorder diagnoses. We are hard at work collaborating with experts in the eating disorder field to bring clarity to the question, “Is it PFD or is it ARFID?” At this time, we feel it is important to rule out PFD when ARFID is diagnosed as PFD will take into account all domains including: Medical, Feeding Skill, Nutrition, and Psychosocial.