What?  More Diagnosis Code Changes? ICD-10 Codes Updated Again

by Barbara Griswold, LMFT (October 2, 2016)

     Diagnosis codes went through a major overhaul last year on October 1, 2015, when we made the transition to ICD-10 codes. This meant new codes for all diagnoses.  Now some of these codes have been updated again, and there are some new codes that should be used for sessions starting October 1, 2016.

The updates affect 14 mental health diagnoses, including codes for frequently-used diagnoses such as Obsessive-Compulsive Disorder, Disruptive Mood Dysregulation Disorder, Hoarding Disorder, Binge-Eating Disorder, Premenstrual Dysphoric Disorder, and Gender Dysphoria in Adolescents and Adults, to name a few.  To view a list of code changes and a chart with the old and new codes, click here.

Codes were updated in part so that diagnoses that were new in the DSM-5 now had their own individual codes, instead of sharing codes with older diagnoses.  It is now clearer which diagnosis you are giving with a code. In addition, the update is part of an ongoing move toward more specificity in diagnostic coding.

It is unclear whether insurance plans will allow some “grace period” during which time they will accept the old codes.
It is important to note that due to these updates, these new codes will no longer match those in the DSM-5.  Providers should continue to use the DSM-5 to determine the correct diagnosis, but then use the new codes for these 14 diagnoses.
In addition, providers are warned to avoid “Unspecified” diagnoses, which may no longer be covered by insurance plans, as they move toward increasing specificity.
For more articles on last year’s ICD-10 transition, and the relationship between the DSM-5 diagnoses and ICD-10 codes, check out my articles page at www.theinsurancemaze.com/articles