Understand Prolonged Grief Disorder (PGD) diagnosis criteria, symptoms, and treatment. Find information on PGD ICD-10 code F43.81, DSM-5 diagnostic criteria, clinical documentation requirements, bereavement support resources, grief counseling, and complicated grief management for healthcare professionals. Learn about assessment tools, differential diagnosis considerations, and evidence-based treatment approaches for prolonged grief.
Also known as
Prolonged Grief Disorder
Persistent intense grief beyond expected timeframe.
Other adjustment disorders
Adjustment disorders with other specified predominant disturbance.
Other reactions to severe stress
Includes disorders like complicated grief if not meeting PGD criteria.
Problems related to life mgmt difficulty
May be used for social/occupational issues due to grief.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is grief reaction prolonged and impairing?
Yes
Death of close person >12 months ago (adult) or >6 months ago (child)?
No
Do not code as F43.81. Consider normal bereavement or other appropriate code.
When to use each related code
| Description |
|---|
| Persistent intense grief after a loss. |
| Major depressive episode triggered by a loss. |
| Adjustment disorder with depressed mood. |
Coding F43.21 without sufficient documentation differentiating it from normal bereavement or adjustment disorder increases audit risk.
Prolonged Grief Disorder may coexist with MDD or PTSD. Accurate coding requires clear documentation of distinct symptoms for each diagnosis.
Coding F43.21 before 12 months of bereavement (or 6 months for children) is inappropriate and poses a compliance risk.
Q: How to differentiate Prolonged Grief Disorder (PGD) from Major Depressive Disorder (MDD) in clinical practice when assessing bereaved patients?
A: Differentiating Prolonged Grief Disorder (PGD) from Major Depressive Disorder (MDD) in bereaved patients requires careful assessment of the primary focus of distress. In PGD, the intense yearning and preoccupation center around the deceased, with thoughts and memories constantly intruding. While sadness and loss of interest may be present, they are directly tied to the loss. In MDD, the depressed mood is more pervasive and not solely focused on the deceased. Feelings of worthlessness, generalized anhedonia, and suicidal ideation may be more prominent in MDD. Consider implementing structured interviews, such as the Inventory of Complicated Grief (ICG) and the Patient Health Questionnaire (PHQ-9), to aid in the differential diagnosis. Explore how integrating grief-specific assessments into your practice can improve diagnostic accuracy and inform treatment planning for bereaved individuals. Learn more about the specific criteria for PGD and MDD in the DSM-5-TR.
Q: What are evidence-based interventions for Prolonged Grief Disorder (PGD) that clinicians can effectively implement in their practice?
A: Evidence-based interventions for Prolonged Grief Disorder (PGD) primarily include Complicated Grief Therapy (CGT) and prolonged grief-focused Cognitive Behavioral Therapy (CBT). CGT focuses on resolving grief complications through revisiting the loss narrative, identifying maladaptive grief reactions, and promoting adaptive coping mechanisms. CBT adapts core cognitive and behavioral techniques to address grief-related thoughts and behaviors. Both therapies have demonstrated efficacy in reducing PGD symptoms. Consider implementing these targeted therapies and exploring training opportunities to develop proficiency in their application. Learn more about the practical application of CGT and CBT for PGD in different clinical settings.
Patient presents with Prolonged Grief Disorder (PGD), also known as complicated grief, persistent complex bereavement disorder, and traumatic grief, following the death of their spouse 18 months ago. Symptoms of prolonged grief reaction, including intense yearning for the deceased, persistent emotional pain related to the loss, preoccupation with thoughts of the deceased, and difficulty accepting the death, significantly impair the patient's social, occupational, and overall functioning. Diagnostic criteria for PGD, as outlined in the DSM-5-TR, are met, with the duration and intensity of grief exceeding what is considered culturally normative. The patient reports symptoms of intrusive thoughts, avoidance behaviors related to reminders of the deceased, emotional numbness, and feelings of disbelief and bitterness. They endorse a sense of meaninglessness in life since the loss and experience difficulty engaging in previously enjoyed activities. Differential diagnoses considered included major depressive disorder and post-traumatic stress disorder, but the patient's predominant focus on the deceased and yearning for their return align more closely with a PGD diagnosis. Treatment plan includes grief counseling, specifically complicated grief therapy (CGT), focusing on processing the loss, managing grief reactions, and facilitating adaptation to life without the deceased. Referral to a bereavement support group and consideration of adjunctive pharmacotherapy for associated anxiety and sleep disturbance will be discussed in subsequent sessions. Patient education regarding the course of prolonged grief and available resources was provided. Prognosis for symptom reduction and improved functioning with appropriate intervention is favorable. Follow-up appointment scheduled in two weeks to monitor progress and adjust treatment as needed. ICD-10 code F43.81 and CPT code 90837 for psychotherapy are applicable.