Introduction

Antisocial Personality Disorder (ASPD), referred to as Dissocial Personality Disorder in the ICD-10 classification, presents unique challenges in both clinical management and documentation. Accurate coding is essential for billing, reimbursement, and maintaining precise clinical records that support continuity of care.

This guide walks through the ICD-10 code F60.2—comparing DSM-5 and ICD-10 diagnostic criteria, coding guidelines, common pitfalls, and co-occurring conditions—to ensure your documentation is accurate, compliant, and clinically valuable.

Understanding ICD-10 Code F60.2: Dissocial (Antisocial) Personality Disorder

• ICD-10 Code: F60.2

• WHO Description: Dissocial personality disorder

• U.S. ICD-10-CM Description: Antisocial personality disorder

Key features include:

• Callous disregard for others

• Irresponsibility and rule-breaking behavior

• Low frustration tolerance and aggression

• Incapacity to feel guilt or learn from punishment

Synonyms include: psychopathic, sociopathic, asocial, and amoral personality disorders.

Note: F60.2 is a billable code under ICD-10-CM and should be used when ASPD is clearly diagnosed.

Diagnostic Criteria: ICD-10 vs. DSM-5

ICD-10 Criteria for F60.2 (Dissocial Personality Disorder)

Requires general personality disorder traits plus at least three of the following:

• Callous unconcern for others

• Persistent irresponsibility

• Inability to sustain long-term relationships

• Low frustration tolerance

• Lack of remorse

• Blaming others or rationalizing antisocial behavior

Persistent irritability may be present. A history of Conduct Disorder is common but not required.

DSM-5 Criteria for ASPD (Also Coded F60.2)

DSM-5 defines ASPD as a pervasive pattern of disregard for others, starting before age 15, with diagnosis made after age 18.

Must include:

• History of Conduct Disorder before age 15

• At least three behavioral criteria (e.g., deceitfulness, aggressiveness, lack of remorse)

• Exclusion: Symptoms must not occur exclusively during schizophrenia or bipolar disorder

Clinical Tip: Document whether ICD-10 or DSM-5 criteria were used and provide evidence such as age or conduct disorder history.

Essential Coding Guidelines for F60.2 (ASPD)

• Use Specific Code: Use F60.2 for a confirmed diagnosis. Avoid vague codes like F60.9.

• Provider Documentation: Must be diagnosed and recorded by a licensed clinician. Avoid coding from terms like "antisocial traits" alone.

• Context Matters: Even if ASPD isn’t the primary concern, code it if it affects care.

• Age Restriction: Do not assign F60.2 for patients under 18—use F91.- (Conduct Disorder) or Z72.810.

• ICD-11 Consideration: Some regions use ICD-11, which treats ASPD differently. In the U.S., use ICD-10-CM unless otherwise required.

• Payer Policies: Reimbursement may require documentation of medical necessity, especially for psychotherapy.

Avoiding Common Coding Pitfalls

• Misunderstanding “Antisocial”: It means rule-breaking behavior, not introversion.

• Ignoring Age Limits: Never use F60.2 for minors.

• Confusing Diagnoses: Borderline (F60.3) or Narcissistic (F60.81) may overlap but must be coded distinctly.

• Overlooking Synonyms: Terms like “psychopathic personality” can still be coded as F60.2 if used by a provider.

• Unspecified Codes: Use F60.9 only when type is truly unclear.

• Omitting Secondary Diagnoses: Include F60.2 if it affects treatment, even when another condition is primary.

Coding Comorbid Conditions and Related Factors

ASPD often co-occurs with other mental and physical conditions. Document all that are clinically relevant:

Common Comorbidities:

• Substance Use Disorders: Alcohol (F10.20), other substances (F11-F19)

• Mood & Anxiety Disorders: Depression (F32/F33), anxiety (F40-F41), PTSD (F43.1)

• Other PDs: Borderline (F60.3), Narcissistic (F60.81)

• ADHD/Conduct Disorder: F90.x for ADHD; Z86.59 or F91.- for Conduct Disorder history

• Psychosocial Stressors: Use Z codes like Z65.1 (incarceration), Z65.0 (legal issues), or Z59.0 (homelessness)

• Medical Issues: Code physical conditions separately (e.g., TBI, Hepatitis C)

Tools like Nudge AI Scribe can help streamline documentation for complex clinical presentations.

Conclusion: Ensuring Accuracy and Clarity

Accurate coding of ASPD using F60.2 requires:

• Adherence to diagnostic standards (DSM-5 or ICD-10)

• Proper provider documentation

• Awareness of coding rules and payer policies

• Inclusion of relevant comorbidities

Modern tools and workflows can support more consistent, high-quality documentation—leading to better treatment planning and care outcomes for patients with ASPD.

Quick Reference: Summary of Key Points for Coding F60.2

• ✅ Correct Code: Use F60.2 for ASPD; avoid F60.9 unless diagnosis is unspecified.

• 📋 Diagnostic Criteria: Reflect either ICD-10 or DSM-5, with appropriate documentation.

• 🧑‍⚕️ Age Compliance: Do not code F60.2 for patients under 18.

• 🔍 Specificity: Recognize and code based on provider language (e.g., "psychopathic").

• ⚠️ Common Pitfalls: Misuse of age, confusion with other PDs, vague documentation.

• ➕ Code Coexisting Conditions: Always include relevant SUDs, PDs, mood disorders, etc.

• 💡 Efficiency Tip: Use tech tools to help capture detailed, compliant clinical data.