Wiki anxiety/depression

[alexander]

Hi
My fellow coders and I have different ideas about the coding of the diagnosis of anxiety depression. I say 300.4. Any one know for sure? Code description is throwing coders off.

 

[kr2011]

Anxiety/Depression

I do not work as a coder, but I do data entry/minor billing duties. At work I am allowed to change codes and review them because of my CPC-A license, about 1000 times a day. Every time I came accross this it has been 300.4. From the ICD book and my software at work this is the code. Medicare will pay it and does recognize it as accurate so I say go for it.

 

[kevbshields]

I knew that sooner or later this would surface on here. I call it the Mental Health Great Diagnosis Debate. Technically speaking, a patient who has "anxious depression" or "depression with anxiety" is considered to have Dysthymia, as the clinical indications per DSM support.

However, for some reason there are providers who service patients (I usually saw Fam Practice & Intern. Med doing it) and will document as follows:

"1.) Depression. Continue Lexapro, consider Psych consult, . . .

2.) Anxiety. Counselled patient on biofeedback methods, continue current meds. Consider antixyolitic later."

The problem is, some providers treat the conditions as if they are unrelated, while others (the Psychologists and Psychiatrists) usually view them as inter-related.

Although I do not have and have been unable to find any clear cut methods to recommend for ICD-9, I find it an interesting "riddle" that has yet to be solved.

Whether the diagnosis is payable has little to do with what is the most approriate capture for this/these disorders. We're aiming at accuracy, not necessarily reimbursement.

Good luck.

 

[alexander]

anxiety depression

thank you Kevin & Kevbshield