The following bullet points quickly clarify the key points of ICD‐10‐CM coding and implementation most relevant to mental health clinicians. We encourage all clinicians to review and ensure their familiarity with these important concepts.
Darrel A. Regier, M.D., M.P.H. Vice‐Chair, DSM‐5 Task Force
- On October 1, 2015, the entire health care system in the U.S. will change its diagnostic codes from ICD‐9‐CM to ICD‐10‐CM. Everyone is now using ICD‐9‐CM codes; mental health practitioners know these codes from using the DSM‐IV‐TR (they are also included in the DSM‐5).
- DSM‐5 contains all of the information needed to assign HIPAA‐compliant, valid ICD‐10‐CM codes to the psychiatric diagnoses that you make for your patients.
Understanding ICD‐10‐CM and DSM‐5
A Quick Guide for Psychiatrists and Other Mental Health Clinicians
Among the most noticeable revisions to the Fifth Edition of Diagnostic and Statistical Manual of Mental Disorders (DSM‐5) is the inclusion of dual codes for every mental disorder to account for the currently used ICD‐9‐CM codes as well as new ICD‐10‐CM codes, which will be activated in October 2015. Since DSM‐5 was released in May 2013, there have been questions about the need for additional clinician training related to the use of the ICD‐10‐CM codes. Because of the listing of the ICD‐10‐CM codes in the DSM‐5, training that is focused solely on the ICD‐10‐CM is not necessary for clinicians to learn the appropriate codes for submitting insurance claims for DSM‐5 mental disorder diagnoses. In the same manner that most mental health clinicians used the ICD‐9‐CM codes embedded in DSM‐III, DSM‐III‐R, DSM‐IV or DSM‐IV‐TR for submitting insurance claims, and never purchased a separate ICD‐9‐CM, it will also be possible to use the embedded ICD‐10‐CM codes in DSM‐5 without the need for additional training. Please note that ICD‐10‐CM does not include diagnostic criteria, and the presence of documented DSM‐5 diagnostic criteria in patient medical records is used by CMS and private insurance contractors for medical chart quality assessment, audit, and fraud/abuse determinations. However, it may be of benefit for clinicians to experience ICD‐10‐CM training in order to better understand the coding of other medical disorders—particularly in settings where general medical and mental health services are treated in an integrated setting. The APA will be posting a compendium of ICD‐10‐CM codes for frequently encountered non‐mental health disorders that can be used as a reference for psychiatrists when reporting patient’s comorbid medical diagnoses.