I would like to know if y'all are still going to utilize the DSM with the expectant arrival of ICD10 this year. APA is wanting to charge a fee to the EHR/Billing programs we use and this fee will pretty much apply to anyone using our system.
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Wiki Dsm5/icd10
- Thread starter LisaAnn
- Start date
mitchellde
True Blue
The DSM codes are not used on claims. Whether there is a correlation between the DSM5 and ICD-10 CM I do not know.
Leenahz
Guru
Right now, our agency plans to use DSM-5 for the EHR and our PM software will cross it over to ICD-10. We're going to have to work out some kinks, I'm sure, but this is our plan for right now.
Lena
Lena
SMCcoding@comcast.net
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Director of AR
We are also crosswalking over from DSM5 to ICD10 with the help of our EHR. Does anyone know if someone who's knowledgable in this process and able to come to the Northeast to train our clinicians?
We are also crosswalking over from DSM5 to ICD10 with the help of our EHR. Does anyone know if someone who's knowledgable in this process and able to come to the Northeast to train our clinicians?
Leenahz
Guru
Hi SMC,
I'm not sure what state you're in, but our clinicians are starting out with webinars offered by SAMHSA, National Council for Behavioral Health, and APA. There's a six or seven part webinar course starting next week, I believe, offered by the APA for approximately $150. After our clinicians have completed the (mandatory) webinars we will have an on-site guest speaker. Then, our Info Management Department will train clinicians on how to enter into the EHR.
Lena
jennamiller
Networker
Dsm-5/icd-10
So....Our vendor just rolled our module for DSM-5 and ICD-10. Very furstrated because the vendor has the DSM-5 but they are mapping the DSM-5 to ICD-10. With no option to change the ICD-10. They have no concept of that fact the the direct mapping does not exist.... They pretty much just mapped the 10 codes to 5 like the DSM book has it. Anyone having these issues?
And do any of you have any thoughts on the CMS FAQ that states that as long as we have the code in the right "family" they will not dinge us if we are to get an audit within the first year of ICD-10?
Question 3:
What is a valid ICD-10 code? (Revised 7/31/15)
Answer 3:
All claims with dates of service of October 1, 2015 or later must be submitted with a valid ICD-10 code; ICD-9 codes will no longer be accepted for these dates of service. ICD-10-CM is composed of codes with 3, 4, 5, 6 or 7 characters. Codes with three characters are included in ICD-10-CM as the heading of a category of codes that may be further subdivided by the use of fourth, fifth, sixth or seventh characters to provide greater specificity. A three-character code is to be used only if it is not further subdivided. While diagnosis coding to the correct level of specificity is the goal for all claims, for 12 months after ICD-10 implementation, if a valid ICD-10 code from the right family (see question 5) is submitted, Medicare will process and not audit valid ICD-10 codes unless such codes fall into the circumstances described in more detail in Questions 6 & 7.
An example is C81 (Hodgkin?s lymphoma) ? which by itself is not a valid code. Examples of valid codes within category C81 contain 5 characters, such as:
C81.00 Nodular lymphocyte predominant Hodgkin lymphoma, unspecified site
C81.03 Nodular lymphocyte predominant Hodgkin lymphoma, intra-abdominal lymph nodes
C81.10 Nodular sclerosis classical Hodgkin lymphoma, unspecified site
C81.90 Hodgkin lymphoma, unspecified, unspecified site
During the 12 month after ICD-10 implementation, using any one of the valid codes for Hodgkin?s lymphoma (C81.00, C81.03, C81.10 or C81.90) would not be cause for an audit under the recently announced flexibilities.
In another example, a patient has a diagnosis of G43.711 (Chronic migraine without aura, intractable, with status migrainosus). Use of the valid codes G43.701 (Chronic migraine without aura) or G43.719 (Chronic migraine without aura, intractable without status migrainosus) instead of the correct code, G43.711, would not be cause for an audit under the audit flexibilities occurring for 12 months after ICD-10 implementation, since they are all in the same family of codes.
Many people use the terms ?billable codes? and ?valid codes? interchangeably. A complete list of the 2016 ICD-10-CM valid codes and code titles is posted on the CMS website at http://www.cms.gov/Medicare/Coding/ICD10/2016-ICD-10-CM-and-GEMs.html. The codes are listed in tabular order (the order found in the ICD-10-CM code book). This list should assist providers who are unsure as to whether an additional 4th, 5th, 6th or 7th character is needed. Using this free list of valid codes is straightforward. Providers can practice identifying and using valid codes as part of acknowledgement testing with Medicare, available through September 30, 2015. For more information about acknowledgement testing, contact your Medicare Administrative Contractor,
So....Our vendor just rolled our module for DSM-5 and ICD-10. Very furstrated because the vendor has the DSM-5 but they are mapping the DSM-5 to ICD-10. With no option to change the ICD-10. They have no concept of that fact the the direct mapping does not exist.... They pretty much just mapped the 10 codes to 5 like the DSM book has it. Anyone having these issues?
And do any of you have any thoughts on the CMS FAQ that states that as long as we have the code in the right "family" they will not dinge us if we are to get an audit within the first year of ICD-10?
Question 3:
What is a valid ICD-10 code? (Revised 7/31/15)
Answer 3:
All claims with dates of service of October 1, 2015 or later must be submitted with a valid ICD-10 code; ICD-9 codes will no longer be accepted for these dates of service. ICD-10-CM is composed of codes with 3, 4, 5, 6 or 7 characters. Codes with three characters are included in ICD-10-CM as the heading of a category of codes that may be further subdivided by the use of fourth, fifth, sixth or seventh characters to provide greater specificity. A three-character code is to be used only if it is not further subdivided. While diagnosis coding to the correct level of specificity is the goal for all claims, for 12 months after ICD-10 implementation, if a valid ICD-10 code from the right family (see question 5) is submitted, Medicare will process and not audit valid ICD-10 codes unless such codes fall into the circumstances described in more detail in Questions 6 & 7.
An example is C81 (Hodgkin?s lymphoma) ? which by itself is not a valid code. Examples of valid codes within category C81 contain 5 characters, such as:
C81.00 Nodular lymphocyte predominant Hodgkin lymphoma, unspecified site
C81.03 Nodular lymphocyte predominant Hodgkin lymphoma, intra-abdominal lymph nodes
C81.10 Nodular sclerosis classical Hodgkin lymphoma, unspecified site
C81.90 Hodgkin lymphoma, unspecified, unspecified site
During the 12 month after ICD-10 implementation, using any one of the valid codes for Hodgkin?s lymphoma (C81.00, C81.03, C81.10 or C81.90) would not be cause for an audit under the recently announced flexibilities.
In another example, a patient has a diagnosis of G43.711 (Chronic migraine without aura, intractable, with status migrainosus). Use of the valid codes G43.701 (Chronic migraine without aura) or G43.719 (Chronic migraine without aura, intractable without status migrainosus) instead of the correct code, G43.711, would not be cause for an audit under the audit flexibilities occurring for 12 months after ICD-10 implementation, since they are all in the same family of codes.
Many people use the terms ?billable codes? and ?valid codes? interchangeably. A complete list of the 2016 ICD-10-CM valid codes and code titles is posted on the CMS website at http://www.cms.gov/Medicare/Coding/ICD10/2016-ICD-10-CM-and-GEMs.html. The codes are listed in tabular order (the order found in the ICD-10-CM code book). This list should assist providers who are unsure as to whether an additional 4th, 5th, 6th or 7th character is needed. Using this free list of valid codes is straightforward. Providers can practice identifying and using valid codes as part of acknowledgement testing with Medicare, available through September 30, 2015. For more information about acknowledgement testing, contact your Medicare Administrative Contractor,
Lydia Helmholz
New
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DSM verses ICD-10
This is a copy of an email I sent to our local Medicaid and Medicare contact but have not received a reply;
In preparation for ICD-10 we have a few questions regarding the CMS supporting documentation requirements for behavioral health services; mental health counseling and chemical dependency counseling. While most of the mental health DSM 5 descriptions match the ICD-10 descriptions the chemical dependency descriptions do not. Per CMS;
Yes. It is expected that clinicians may continue to base their diagnostic decisions on the DSM-IV/DSM-5 criteria. In addition, it is still perfectly permissible for providers and others to use the DSM-IV and DSM-5 descriptors and diagnostic criteria for other purposes, including medical records, quality assessment, medical review, consultation, and patient communications.
Once the clinician has arrived at the clinical diagnosis and documented it in the medical record, the appropriate diagnosis code(s) should be assigned. Code assignment can be accomplished using a variety of resources. These resources may include ICD-10-CM code books, specialty specific code books, electronic versions of the ICD-10-CM posted on CMS? website at http://www.cms.gov/Medicare/Coding/ICD10/index.html and the CDC website at http://www.cdc.gov/nchs/icd.htm, and encoders.
ICD-9-CM codes should be used for reporting the diagnosis codes associated with services furnished up to, and including, September 30, 2015. As of October 1, 2015, the ICD-10-CM code set will become the HIPAA adopted standard and will be required for reporting diagnosis codes for dates of service on and after October 1, 2015.
DSM-5 contains the standard criteria and definitions of mental disorders now approved by the American Psychiatric Association (APA), and it also contain both ICD-9-CM and ICD-10-CM codes (in parentheses) selected by APA. Since DSM-IV only contains ICD-9-CM codes, it will cease to be recognized for criteria or coding for services with dates of service of October 1, 2015 or later. Updates for DSM-5 criteria and their associated ICD-10-CM codes (identified by APA) will be found at http://www.dsm5.org.
Does this mean the DSM 5 description will satisfy the ICD-10 documentation requirements if different, as with the Chemical dependency codes?
Examples:
1. Alcohol Use Disorder, Mild = Alcohol Abuse, uncomplicated F10.10
2. Alcohol Use Disorder, Moderate = Alcohol Dependence, uncomplicated F10.20
3. Alcohol Use Disorder, Severe = Alcohol Dependence, uncomplicated F10.20
Thank you in advance for your assistance, please forward this question to appropriate personnel if you do not have answer, we will interpret the CMS language above as stating we can use the DSM 5 description for documentation purposes.
This is a copy of an email I sent to our local Medicaid and Medicare contact but have not received a reply;
In preparation for ICD-10 we have a few questions regarding the CMS supporting documentation requirements for behavioral health services; mental health counseling and chemical dependency counseling. While most of the mental health DSM 5 descriptions match the ICD-10 descriptions the chemical dependency descriptions do not. Per CMS;
Yes. It is expected that clinicians may continue to base their diagnostic decisions on the DSM-IV/DSM-5 criteria. In addition, it is still perfectly permissible for providers and others to use the DSM-IV and DSM-5 descriptors and diagnostic criteria for other purposes, including medical records, quality assessment, medical review, consultation, and patient communications.
Once the clinician has arrived at the clinical diagnosis and documented it in the medical record, the appropriate diagnosis code(s) should be assigned. Code assignment can be accomplished using a variety of resources. These resources may include ICD-10-CM code books, specialty specific code books, electronic versions of the ICD-10-CM posted on CMS? website at http://www.cms.gov/Medicare/Coding/ICD10/index.html and the CDC website at http://www.cdc.gov/nchs/icd.htm, and encoders.
ICD-9-CM codes should be used for reporting the diagnosis codes associated with services furnished up to, and including, September 30, 2015. As of October 1, 2015, the ICD-10-CM code set will become the HIPAA adopted standard and will be required for reporting diagnosis codes for dates of service on and after October 1, 2015.
DSM-5 contains the standard criteria and definitions of mental disorders now approved by the American Psychiatric Association (APA), and it also contain both ICD-9-CM and ICD-10-CM codes (in parentheses) selected by APA. Since DSM-IV only contains ICD-9-CM codes, it will cease to be recognized for criteria or coding for services with dates of service of October 1, 2015 or later. Updates for DSM-5 criteria and their associated ICD-10-CM codes (identified by APA) will be found at http://www.dsm5.org.
Does this mean the DSM 5 description will satisfy the ICD-10 documentation requirements if different, as with the Chemical dependency codes?
Examples:
1. Alcohol Use Disorder, Mild = Alcohol Abuse, uncomplicated F10.10
2. Alcohol Use Disorder, Moderate = Alcohol Dependence, uncomplicated F10.20
3. Alcohol Use Disorder, Severe = Alcohol Dependence, uncomplicated F10.20
Thank you in advance for your assistance, please forward this question to appropriate personnel if you do not have answer, we will interpret the CMS language above as stating we can use the DSM 5 description for documentation purposes.
jennamiller
Networker
Just to piggy back we are in Jurisdiction 6. NGS has published LCD's and they are using that. So that is what will be followed when submitting claims.....There are few to none unspecified codes listed...Let me know when you hear back on your question.