Pathological gambling

This code identifies a persistent and recurrent maladaptive gambling behavior that disrupts personal, family, or vocational pursuits. It is characterized by an increasing preoccupation with gambling, a need to gamble with increasing amounts of money to achieve the desired excitement, and repeated unsuccessful efforts to control, cut back, or stop gambling.

Assign this code when documentation clearly indicates a diagnosis of pathological gambling, often presenting with financial difficulties, relationship problems, or legal issues directly attributable to the gambling behavior. Supporting documentation should reflect diagnostic criteria such as tolerance, withdrawal symptoms, or repeated attempts to cut down.

• Differentiate from recreational gambling (Z72.6) which does not involve a pathological pattern.
• Do not use for gambling associated with manic episodes (F30, F31) or as a feature of antisocial personality disorder (F60.2).
• Ensure provider documentation specifies "pathological" gambling to support this specific diagnosis.