Bulimia nervosa, extreme

This code signifies a severe form of bulimia nervosa, an eating disorder characterized by recurrent episodes of binge eating followed by inappropriate compensatory behaviors (e.g., self-induced vomiting, laxative misuse, excessive exercise). The "extreme" specifier indicates a very high frequency of compensatory behaviors, typically averaging 14 or more episodes per week.

Apply this code when documentation clearly indicates a diagnosis of bulimia nervosa with extreme severity, based on the frequency of compensatory behaviors. This typically requires a clinician's assessment and explicit statement of "extreme" severity or a detailed description of compensatory behaviors meeting the frequency criteria.

• Ensure the medical record explicitly states "extreme" severity or provides sufficient detail to support the frequency of compensatory behaviors (14+ per week).
• Differentiate from other severity levels of bulimia nervosa (e.g., F50.20, F50.21, F50.22, F50.23) based on the documented frequency of compensatory behaviors.
• Code any associated physical complications (e.g., electrolyte imbalances, dental erosion) separately.