What are dsm codes
ICD and DSM Coding: What’s the Difference?
There is a lot of talk these days about CMS’ impending required change from ICD-9 to ICD-10. The coming change, due to occur on October 1, 2015, is designed to let medical organizations take advantage of a greatly expanded and much more detailed code set.
ICD was created and is maintained by the World Health Organization (WHO), as the codes are used to communicate medical information worldwide.
Some medical practices and revenue cycle management (RCM) companies, especially those dealing with behavioral health (BH), will also want to know about the differences between ICD and DSM (Diagnostic and Statistical Manual of Mental Disorders) codes.
What is ICD Coding?
ICD includes thousands of codes that medical professionals use to document illnesses and diagnoses, making claims more highly specific in terms of information to insurance companies.
ICD was (and is) developed by WHO, an international organization responsible for updating codes for users worldwide. By having an international standard for such coding, international collaboration is much more effective. We live in an increasingly smaller world, and research done in one country is made more easily applicable in other countries in part due to these universal codes used by practitioners.
What is DSM Coding?
The latest version of the Diagnostic and Statistical Manual of Mental Disorders is DSM-5. It is designed to make the ICD-10 transition go as smoothly as possible for insurance carriers and medical care providers by still using the CM codes (U.S. Clinical Modifications) in the ICD code.
Unlike ICD, DSM is published by the American Psychiatric Association.
Connections Between ICD and DSM
DSM has connections to ICD which are often referred to as “crosswalks” or “bridges.”
Practices or BH settings using DSM can use crosswalks to help practitioners use their DSM codes with ICD codes when submitting claims.
Ultimately, BH providers will need to become familiar with ICD-10 codes and learn how to use bridges or crosswalks between the DSM codes and the ICD codes.
BH providers will benefit from training and practice to help them with their documentation as the entire medical community switches to ICD-10 on October 1, 2015.
It’s also worth noting that that the WHO has published the ICD-10 Classification of Mental and Behavioral Disorders Clinical Descriptions and Diagnostic Guidelines (aka “blue book”) to help BH providers determine diagnoses.
Medical practices and RCM companies will need to get ready for the upcoming transition to ICD-10 from ICD-9. Those that work with DSM codes should know DSM codes can be used in making their diagnoses, but because DSM codes are not HIPAA compliant, the appropriate ICD code(s) will be needed for documentation.
As BH providers become more familiar with ICD-10, they will be able to more easily enter the correct codes from their DSM-based assessments.
Key Takeaway:
- ICD-9 is transitioning to ICD-10 on October 1, 2015. The last day for ICD-9 is September 30, 2015.
- Connections exist between the latest version DSM-5 and the ICD-10 code set.
- DSM codes are not HIPAA-compliant, which means ICD-10 codes will be needed for claims.
- The American Psychiatric Association is establishing “crosswalks” or “bridges” to help in using DSM-5 to support their diagnoses as they enter the proper ICD-10 codes which are needed for HIPAA compliance.
Information in ADSC Blogs is presented according to our best understanding of the subject as derived from sources such as CMS. Any uncertainty on the part of the reader, or any clarifications that may be required should be researched as needed by the reader.
Photo Courtesy of: freedigitalphotos.net
What You Need to Know About DSM-5 and ICD-10-CM
Michael B. First, MD
Psychiatric TimesVol 32 No 8
Volume 32
Issue 8
The good news? Compared with our non-psychiatric colleagues, we psychiatrists are in very good shape when it comes to switching over to ICD-10-CM.
(Hint: There are no DSM codes)
Since 1979, all clinicians-psychiatrists and non-psychiatrists-who practice in the US have had to submit valid ICD-9-CM diagnostic codes with their billing submissions in order to meet government- and insurer-imposed coding requirements. Starting October 1, 2015, we will have to switch from ICD-9-CM to a new coding system, ICD-10-CM.
The reason for this switchover is straightforward: ICD-9-CM was simply running out of codes. ICD-9-CM is a 5-digit numerical coding system that contains approximately 13,000 codes. ICD-10-CM is an alpha-numeric system that contains approximately 68,000 codes: each code starts with a letter followed by anywhere from 2 to 7 numbers. Moreover, these additional available codes allow the clinician to be much more specific when communicating information about the patient’s diagnostic condition. For example, there is a single ICD-9-CM code for diabetes mellitus complicating pregnancy or childbirth: 648.01. In ICD-10-CM, there are 21 corresponding ICD-10-CM codes that require you to indicate whether the diabetes is type 1 or type 2; whether it developed during the first, second, or third trimester or during childbirth; or whether it predated the pregnancy.
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For most clinicians, the ICD-9-CM to ICD-10-CM transition requires extensive retraining of themselves and their staff so that they can take advantage of the increased specificity and maximize appropriate reimbursement. The transition has also required a massive reprogramming of billing and other data collection systems to accommodate the new code set. For this reason, over the years there has been pushback from both the clinical and administrative communities to delay implementation of ICD-10-CM.
In fact, its implementation has already been delayed twice. It was originally scheduled for implementation on October 1, 2013, but postponed to 2014. Then, last year-under pressure from the AMA, a provision was added to the annual 1-year “fix” of the Sustainable Growth rate formula for Medicare physician reimbursement. This delayed implementation yet again, this time until October 1, 2015.
But no further delays are likely to happen, and you and your colleagues must now bite the bullet and accept that-in a matter of a few weeks-you will be required to submit bills using ICD-10-CM codes.
The good news? Compared with our non-psychiatric colleagues, psychiatrists are in very good shape when it comes to switching over to ICD-10-CM.
When DSM-5 was published in May 2013, in anticipation of the impending ICD-9-CM to ICD-10-CM switchover, both ICD-9-CM and ICD-10-CM codes were assigned to each of the DSM-5 diagnoses. For example, as can be seen on page 190 of DSM-5, the diagnostic codes for Separation Anxiety Disorder “309.
21 (F93.0)” are listed in the upper right hand corner of the criteria set. In this case, 309.21 is the ICD-9-CM code for Separation Anxiety Disorder, and F93.0 is the ICD-10-CM code. Starting October 1, all you need do to become ICD-10-CM–compliant is to start using F93.0 instead of 309.21 when submitting payment for a case of Separation Anxiety Disorder.
Because the diagnostic codes sometimes reflect the use of applicable specifiers, for some disorders the coding is less straightforward. For example, on page 338 of DSM-5, the criteria set for Anorexia Nervosa does not list any diagnostic codes in the upper right hand corner. This is because the diagnostic code depends on which subtype applies. As is seen on page 339, the ICD-10-CM code is F50.01 for the restricting type (no binge eating or purging episodes during the past 3 months) and F50.02 for the binge eating–purging type (recurrent episodes of binge eating or purging).
The reason that both ICD-9-CM and ICD-10-CM codes are included in DSM-5 is that it came out during the time when clinicians were still required to use ICD-9-CM codes.
Presumably, future printings of DSM-5 will excise the ICD-9-CM codes and will include only the ICD-10-CM codes.
Part of the reason for the impending anxiety among some psychiatrists about what they need to do to become ICD-10-CM–compliant stems from the mistaken notion that they will be required to use ICD-10-CM instead of the “DSM codes” included in DSM-5. There are, in fact, no “DSM codes” in the DSMs. Since DSM-III, diagnostic codes appearing in DSM have all been valid ICD-9-CM codes.
Let me take a short historical detour here to explain yet another major source of confusion about the ICD coding system. Since 1948, the International Classification of Diseases (ICD) has been produced by the World Health Organization (WHO) to promote uniform collection of health statistics around the world. All countries that are members of the WHO are obligated by treaty to use ICD codes for collecting data about medical diagnoses. The current version of the ICD coding system used internationally since 1992 is ICD-10, ie, the 10th revision of the ICD.
Work is now under way by the WHO to produce the next revision, ICD-11, which is expected to be approved by the World Health Assembly in May 2018.
Back in the 1970s, the US government decided that the ICD system was not specific enough for clinical use and developed its own version of the ICD for use in the US. It is called ICD-CM (the CM stands for “Clinical Modification”). The version of the ICD currently used in the US is ICD-9-CM, which became “official” in 1979. So while the rest of the world has been using ICD-10 for reporting health care statistics since the 1990s, the US continues to use the ICD-9-CM system, which is based on the older ICD-9 classification. The US is finally ready to catch up to the rest of the world and implement ICD-10-CM, which as the “CM” designation indicates, is a modified version of ICD-10 for use in the US.
ICD-10-CM was actually ready for use in the US by the mid-1990s, but its implementation was delayed for 20+ years because of opposition from various groups on the grounds that implementation would be costly and not worth it.
What about “differences” between the mental disorders section of ICD-10-CM and DSM-5? Besides the substance use disorder codes (for which there are 3 times as many codes in ICD-10-CM as there are substance use disorders in DSM-5), there are hardly any more diagnostic codes in the mental disorders section of ICD-10-CM as there are in DSM-5. In fact, if you look closely at the mental disorders section of the ICD-10-CM (available on the Web site of the National Center for Health Statistics), you will see that the ICD-10-CM mental disorder section looks essentially the same as DSM-IV-TR in terms of categories and names of disorders. This is not an accident-the APA had a big hand in the development of the ICD-10-CM content and we made a strong effort to get it as close to DSM-IV as possible, since we were expecting the ICD-10-CM to go into effect in the late 1990s, well before any work started on DSM-5.
By the way, the reason for the proliferation of substance use disorder codes is that the ICD-10-CM coding system requires the clinician to combine substance use disorder diagnoses (eg, substance dependence) with substance-induced diagnoses (eg, substance-induced depressive disorder): if you want to make a diagnosis of a substance-induced disorder, you must also indicate the comorbid substance use disorder.
For example, when choosing the diagnostic code for a patient with cocaine-induced depression, you must indicate the comorbid pattern of cocaine use as follows: F14.14 for cocaine-induced depressive disorder occurring in the context of mild cocaine use disorder; F14.24 for cocaine-induced depressive disorder occurring in the context of moderate to severe cocaine use disorder; and F14.94 for cocaine-induced depressive disorder occurring without a comorbid cocaine use disorder (see DSM-5, page 176).
So . . . you don’t need to lose sleep over the coming transition. If you already have a copy of DSM-5, you have all of the codes you need for successful ICD-10-CM implementation.
If you have questions about the coming transition to ICD-10-CM, please post them in the comment box.
| These codes are common to most GSM cell phones. Although these codes are not secret, their use may damage your phone. View IMEI (phone ID) - *#06#. Change PIN - **04*, then enter the old PIN and the new PIN twice. Call forwarding (you must order the service from the operator) Forward unconditional (forward all calls) Forward in case of "no answer" Set the ringing time before triggering "no answer" call forwarding Redirect in case of "not available" Forward on busy Call barring (you must order the service from the operator) Barring all outgoing calls Barring all calls Barring all outgoing international calls Bar all outgoing calls Barring all incoming calls Barring all incoming calls while roaming Call waiting (you must order the service from the operator) Transmit your phone number (Anti Caller ID) Display the number of the phone calling you (AON) How to make the phone work longer? |
Dial the symbols of the codes correctly! 
If during this time you have not picked up the phone, the incoming call will be forwarded. 
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Service codes applicable to most GSM phones. These service codes do not work on smartphones and communicators.
REPLACE PIN
Change PIN 1
**04*oldPIN1*newPIN1*newPIN1#
Change PIN 2
** 042*OldPin2*Newpin2*Newpin2#
Unlock PIN 1
** 05*PUK*Newpin1#
Unlock PIN 2
9000 ** 052*PUK2*NewPin2# newpin2# SHOW IMEI
*#06#
CALL WAITING
Activate call waiting *43#
Deactivate call waiting #43#
Check status of call waiting service *#43#
CALL FORWARDING
•Deactivate all types of call forwarding ##002#
•Deactivate all conditional forwarding ##004#
ALL CALL FORWARDING 900 •13 •Deactivate and Disable call forwarding to another number9 call forwarding #013# another number #21#
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FORWARDING IF THE CALL IS NOT ANSWERED
•Deactivate and disable call forwarding if the subscriber does not answer ##61#
•Disable call forwarding if the subscriber does not answer #61#
•Check the status of call forwarding if the subscriber does not answer *#61#
FORWARDING WHEN THE SUBSCRIBER IS OUTSIDE THE COVERAGE AREA
•Deactivate and disable call forwarding if the subscriber is out of coverage # #62#
•Disable call forwarding if subscriber is out of coverage area #62#
•Check call forwarding status if subscriber is out of coverage area *#62#
FORWARD WHEN THE PHONE IS BUSY
•Deactivate and disable call forwarding if the phone is busy ##67#
•Deactivate call forwarding if the phone is busy #67#
•Check the status of automatic forwarding if the phone is busy *#67#
SET TIME TO ACTIVATION FORWARDS
N = 5-30 (seconds)
• Set the number of rings **61*VoiceMail Number**N#
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ALL CALL BAR
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BARRIING ALL OUTGOING INTERNATIONAL CALLS
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BARRY OF ALL OUTGOING CALLS
•Deactivate barring of all outgoing calls #333*Password#
•Check status of barring of all outgoing calls *#333#
BARRY OF ALL INCOMING CALLS
•Deactivate barring all incoming calls #35*PW# or **353*Password#
•Check status of barring all incoming calls *#35# or *#353#
BARRIING ALL INCOMING CALLS WHILE ROAMING
•Deactivate all incoming call barring while roaming #351*Password#
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