September ICD-10 Action Items
by Leigh-Ann Renz, 9.30.15
Meeting ICD-10 Compliance for Mental / Behavioral Health, Psychiatry and Substance Usage
This Is It
How do you proceed as of 10/1/15? All dates of service 9/30/15 and prior should continue to be diagnosed in ICD-9, as they have been for the past 30+ years (DSM is ICD, so if you’ve been using DSM to diagnose, you’ve been using ICD-9 codes). For all dates of service 10/1/15 and after, you’ll need to diagnose in ICD-10.
For example: binge-eating disorder is 307.51 in ICD-9 but F50.8 in ICD-10. You might diagnose the same client for binge-eating disorder on both September 27th and October 8th – on the 9/27 note/claim, you will use diagnosis code 307.51; but on the 10/8 note/claim, you will use diagnosis code F50.8 instead.
Remember that only ICD codes are changing; CPT codes remain the same. This is why ICD puts the burden on the provider, not the biller or administrative staff! Providers should be using DSM-5 to diagnose mental health, and using ICD-10 codes for dates of service 10/1/15 and after. Because there are often many more options to choose from under ICD-10 (especially when specifiers are calculated), it may take providers much longer to complete notes.
It’s likely that each provider has only a small handful of diagnosis codes that are commonly used. While the transition to ICD-10 is challenging, once the commonly used codes have been correctly converted, the process should become easier. You might want to create cheat sheets for each provider (or perhaps even the whole practice) that lists the ICD-10 conversion options of commonly-used codes.
FAQs for Mental Health ICD-10
> “What if what I’m seeing in my DSM-5 manual doesn’t match what’s in my EHR?”
Make sure that you’re taking into account the DSM-5 updates: there were code changes issued after the manual was printed, and what’s in your printed manual may not be accurate/correct. See page 3 here for the updates.
> “We’ve been using DSM; what do we do now?”
If you’ve been using DSM, you’ve been using ICD-9 codes: DSM is a guide to picking the right ICD code. All providers must use ICD-10 codes for all dates of service 10.1.15 and beyond. You should be using the DSM-5 to diagnose, and it will direct you to the correct ICD-10 code. You can then find this ICD-10 code in your EMR or Practice Management System.
"You must use ICD-10 on claims for services provided on or after October 1. Payment will continue to be based on CPT codes. You can conduct acknowledgement testing at any time with your MAC."
> 8 Steps to a Smooth ICD-10 Transition
Previous Action Items
August: Have You Been Saving? + All Hands on Deck
July: Reality Check + Testing Resources
June: Test with Payers + Focus on Reducing Denials
May: Make Sure Staff Understands + Empower Providers to Begin Dual Coding
April: Schedule Testing + Update Your Practice
March: Update Your Contracts + Start Saving
(Disclaimer: Ultimately, it is the responsibility of each practice to ensure ICD-10 compliance. PIMSY EMR/SMIS has gathered information from various resources believed to be authorities in their field. However, neither PIMSY EMR/SMIS - nor its employees - nor the authors - warrant that the information is in every respect accurate and/or complete. PIMSY EMR/SMIS assumes no responsibility for use of the information provided. Neither PIMSY EMR/SMIS - nor its employees - nor the authors - shall be responsible for, and expressly disclaim liability for, damages of any kind arising out of the use of, reference to, or reliance on, the content of these educational materials. These materials are for informational purposes only. PIMSY EMR/SMIS does not provide medical, legal, financial or other professional advice and readers are encouraged to consult a professional advisor for such advice.)