Adds the dsm5 skill: an evidence-based conversational expert grounded in the DSM-5-TR (American Psychiatric Association, 2022) for clinicians, practitioners, patients, and family members. - SKILL.md: safety-first conversation workflow (triage -> clarify -> route -> compare criteria -> differentials -> calibrated conclusion), reference routing table, crisis protocol, audience adaptation - references/: 28 files — foundation (00-02), all 22 DSM-5-TR diagnostic classes (10-31), Part III measures/culture/AMPD/conditions-for-further- study (32-33), and cross-cutting differentials (40). Criteria are paraphrased with exact counts, durations, specifiers, and ICD-10-CM codes, plus per-disorder clinician and patient/family conversation guides - scripts/lookup.py: stdlib keyword search across the reference library (--json/--list/--max/-q) - evals/evals.json: 9 output-quality cases (schema v1) - README.md: human-facing overview, install notes, and APA attribution - Catalog entries and generated artifacts (llms.txt, marketplace plugins) regenerated; all repo validators pass Co-authored-by: factory-droid[bot] <138933559+factory-droid[bot]@users.noreply.github.com>
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Other Mental Disorders and Additional Codes — DSM-5-TR Companion Reference
Summarized and paraphrased from DSM-5-TR (American Psychiatric Association, 2022). This file is for orientation and education; verify exact criteria wording, codes, and recording procedures against the official DSM-5-TR before any formal clinical, legal, insurance, or research use.
Chapter Overview
This short chapter provides diagnostic codes for psychiatric presentations that are mental disorders — that is, symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning — but that do not meet the diagnostic requirements for any specific disorder in the prior Section II chapters. It also carries one "additional code," Z03.89 No Diagnosis or Condition, for individuals who have been evaluated and determined to have no mental disorder or condition. The four categories here are residual or "catch-all" codes: two for presentations attributable to another medical condition (F06.8, F09) and two for presentations not attributable to a medical condition (F99 for both categories). Clinicians routinely misunderstand these codes as "garbage" categories; in fact they serve a precise recording function when a presentation is clearly a mental disorder but does not fit any named category — and, for the "unspecified" forms, when there is insufficient information for a more specific diagnosis (e.g., in emergency settings).
Note: the chapter title is "Other Mental Disorders and Additional Codes." The separate DSM-5-TR chapter "Other Conditions That May Be a Focus of Clinical Attention" (Z codes, including Suicidal Behavior and Nonsuicidal Self-Injury) is covered in 31-other-conditions-that-may-be-a-focus-of-clinical-attention.md.
Categories in this chapter
| Category | ICD-10-CM code(s) | One-line "what it is" |
|---|---|---|
| Other Specified Mental Disorder Due to Another Medical Condition | F06.8 | Mental-disorder symptoms that are a direct physiological consequence of a medical condition but do not meet full criteria for a specific mental disorder due to another medical condition; the clinician states the reason |
| Unspecified Mental Disorder Due to Another Medical Condition | F09 | Same presentation, but the clinician does not state the reason (often insufficient information) |
| Other Specified Mental Disorder | F99 | Mental-disorder symptoms causing distress/impairment that meet no specific disorder's criteria; the clinician states the reason |
| Unspecified Mental Disorder | F99 | Same presentation, but the clinician does not state the reason (often insufficient information) |
| No Diagnosis or Condition (additional code) | Z03.89 | Person evaluated; no mental disorder or condition is present |
Using the residual categories
The "other specified mental disorder" and "unspecified mental disorder" categories (without the "due to another medical condition" qualifier) are used only when all of the following apply:
- The presentation is a mental disorder — symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- The presentation does not meet the diagnostic criteria for any specific mental disorder in Section II.
- It also does not meet the definitional requirements of any of the other "other specified" / "unspecified" categories presented in Section II.
- No other mental disorder diagnosis applies.
The distinction between the two mirrors the "other specified / unspecified" convention used across every chapter of DSM-5 (see 00-overview-and-method.md):
- Other specified — the clinician chooses to record the specific reason the presentation does not meet criteria for an existing category (e.g., "other specified mental disorder, recurrent brief depression").
- Unspecified — the clinician chooses not to specify the reason; includes presentations with insufficient information to make a more specific diagnosis (e.g., in emergency room settings).
These codes are recorded exactly like the per-chapter residual categories: the code is followed by the recorded name, and when a reason is given it is appended in plain language.
Other Specified Mental Disorder Due to Another Medical Condition
Core features
Applies when symptoms characteristic of a mental disorder due to another medical condition predominate and cause clinically significant distress or impairment, but the full criteria for any specific mental disorder attributable to another medical condition are not met. The clinician communicates the specific reason the criteria are unmet.
Recording procedure
- Record the name of the disorder, with the specific etiological medical condition inserted in place of "another medical condition," followed by the specific symptomatic manifestation that does not meet criteria for a specific mental disorder due to another medical condition.
- The diagnostic code for the medical condition must be listed immediately before the F06.8 code.
- Example as printed: dissociative symptoms due to complex partial seizures are coded and recorded as "G40.209 complex partial seizures, F06.8 other specified mental disorder due to complex partial seizures, dissociative symptoms."
Unspecified Mental Disorder Due to Another Medical Condition
Core features
Applies to the same class of presentations — characteristic symptoms that cause clinically significant distress or impairment but do not meet full criteria for a specific mental disorder due to another medical condition — when the clinician chooses not to specify the reason, including presentations with insufficient information to make a more specific diagnosis (e.g., in emergency room settings).
Recording procedure
- Record the name of the disorder with the specific etiological medical condition inserted in place of "another medical condition"; code the medical condition immediately before F09.
- Example as printed: dissociative symptoms due to complex partial seizures are coded as "G40.209 complex partial seizures, F09 unspecified mental disorder due to complex partial seizures."
Other Specified Mental Disorder
Core features
Applies when symptoms characteristic of a mental disorder that cause clinically significant distress or impairment predominate but do not meet the full criteria for any specific mental disorder, and the clinician chooses to communicate the specific reason the criteria are not met.
Recording procedure
Record "other specified mental disorder" followed by the specific reason (e.g., "other specified mental disorder, [reason]"). No medical condition code precedes it — this category is not tied to an etiological medical condition.
Unspecified Mental Disorder
Core features
Applies to the same kind of presentation when the clinician chooses not to specify the reason the criteria for a specific mental disorder are not met; includes presentations with insufficient information to make a more specific diagnosis (e.g., in emergency room settings).
Recording procedure
Record "unspecified mental disorder" (F99) without a stated reason.
Additional Codes
No Diagnosis or Condition (Z03.89)
Used when the person has been evaluated and it is determined that no mental disorder or condition is present. This code documents that an evaluation occurred and resulted in no diagnosis — distinct from the residual mental-disorder codes above, which are used only when a mental disorder is present but does not fit a named category.
Conversation guide
For clinicians / practitioners
- Reserve F99/F06.8 for presentations that genuinely qualify as mental disorders (clinically significant distress or impairment) yet fit no named category — do not use them as a default for "symptoms I could not categorize," or for presentations better captured by the Z-code chapter (e.g., Z03.89 No Diagnosis or Condition, relational or phase-of-life problems).
- When a medical condition is the presumed etiology, remember the coding rule: list the medical condition's code immediately before F06.8 or F09, and name the medical condition in the recorded diagnosis.
- In emergency settings, F99 is a legitimate placeholder when information is insufficient; document that the code reflects incomplete information, and plan follow-up to reach a specific diagnosis when possible.
- Never let a residual code substitute for a specific diagnosis that the information actually supports.
For patients and family members
- A diagnosis of "unspecified" or "other specified" mental disorder does not mean the clinician thinks symptoms are not real, and it is not a lower-quality diagnosis. It means the person has real, impairing symptoms that do not exactly fit any named disorder, or that there is not yet enough information to name one — common in emergency or first-visit settings.
- These codes are often temporary; a fuller picture over time may allow a specific diagnosis.
- What not to assume: receiving one of these codes does not confirm any particular disorder, and "no diagnosis or condition" (Z03.89) means an evaluation found no mental disorder — not that symptoms were dismissed. Only a qualified clinician can determine whether a diagnosis is present.