Find comprehensive information on Bulimia Nervosa (Bulimia) diagnosis, including clinical documentation, medical coding, and healthcare resources. Learn about diagnostic criteria, treatment options, and best practices for documenting Bulimia in medical records. This resource provides valuable insights for healthcare professionals, clinicians, and medical coders seeking accurate and up-to-date information on Bulimia Nervosa.
Also known as
Bulimia nervosa
Eating disorder with binge eating and purging.
Atypical bulimia nervosa
Bulimia nervosa that doesnt meet full criteria.
Other eating disorders
Includes purging disorder and night eating syndrome.
Unspecified eating disorder
Eating disorder not otherwise specified.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the diagnosis Bulimia Nervosa?
Yes
In remission?
No
Do NOT code as Bulimia Nervosa. Review alternate diagnoses.
When to use each related code
| Description |
|---|
| Recurrent binge eating with compensatory behaviors. |
| Binge eating without compensatory behaviors. |
| Distorted body image, restrictive eating, low weight. |
Coding for unspecified bulimia (F50.2) when purging type (F50.20) or non-purging type (F50.21) is documented, impacting reimbursement and data accuracy.
Missing common comorbidities like anxiety, depression, or substance use disorders, leading to undercoding and inaccurate severity reflection.
Insufficient documentation of frequency, severity, and compensatory behaviors, causing inaccurate severity coding and affecting quality metrics.
Q: What are the most effective evidence-based treatment strategies for adult Bulimia Nervosa in outpatient settings?
A: Cognitive Behavioral Therapy (CBT) and Enhanced Cognitive Behavioral Therapy (CBT-E) are considered the first-line, evidence-based treatments for Bulimia Nervosa in adults within outpatient settings. CBT targets the core psychopathology of Bulimia Nervosa by addressing dysfunctional thoughts and behaviors related to eating, body image, and self-esteem. CBT-E builds upon CBT with additional modules focused on perfectionism, low self-esteem, and interpersonal difficulties, which are often present in individuals with this disorder. Family-Based Treatment (FBT) is another evidence-supported approach, especially for adolescents with Bulimia Nervosa, although its adaptation for adults is showing promise. Dialectical Behavior Therapy (DBT) skills training can also be a helpful adjunct for managing emotional dysregulation often comorbid with Bulimia Nervosa. Explore how integrating motivational interviewing techniques can enhance patient engagement and treatment adherence in these modalities. Consider implementing regular monitoring of symptoms and psychological well-being throughout the treatment process.
Q: How can clinicians differentiate between Bulimia Nervosa and Binge Eating Disorder during the diagnostic assessment process?
A: The key distinction between Bulimia Nervosa and Binge Eating Disorder (BED) lies in the presence of compensatory behaviors following binge eating episodes. In Bulimia Nervosa, individuals engage in recurrent inappropriate compensatory behaviors, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise, to prevent weight gain after binge eating. BED, on the other hand, is characterized by recurrent binge eating episodes *without* the regular use of compensatory behaviors. During assessment, clinicians should carefully inquire about the frequency, type, and duration of binge eating episodes, as well as the presence and nature of any compensatory behaviors. Exploring the patient's thoughts and feelings surrounding body shape, weight, and eating behaviors is also crucial for accurate diagnosis. Learn more about the specific diagnostic criteria for both Bulimia Nervosa and BED outlined in the DSM-5 to ensure a thorough and precise assessment.
Patient presents with concerns consistent with bulimia nervosa. The patient reports episodes of binge eating characterized by consumption of an unusually large amount of food in a discrete period (e.g., within any 2-hour period) accompanied by a sense of lack of control over eating during the episode. These binge eating episodes are followed by inappropriate compensatory behaviors to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise. The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for three months. Self-evaluation is unduly influenced by body shape and weight. The disturbance does not occur exclusively during episodes of anorexia nervosa. Differential diagnosis includes binge eating disorder, anorexia nervosa binge-purge subtype, and other specified feeding or eating disorder. Assessment includes detailed history of eating patterns, body image concerns, compensatory behaviors, and associated medical complications such as electrolyte imbalances, esophageal inflammation, and dental erosion. Current weight and height were obtained and BMI calculated. Mental status exam reveals preoccupation with weight and shape. Treatment plan includes referral for medical evaluation to address potential medical complications, nutritional counseling to establish healthy eating patterns, and cognitive behavioral therapy (CBT) or other evidence-based psychotherapy to address underlying psychological factors contributing to the bulimia nervosa. Patient education regarding the nature of the disorder, its course, and treatment options was provided. Prognosis, potential complications, and the importance of adherence to the treatment plan were discussed. Follow-up appointments were scheduled to monitor progress and adjust treatment as needed.