I'd be reluctant to code from arrows at all--regardless of IP or OP setting.
The other thing: did the Psychiatrist treat, manage or observe the Axis III condition or was it simply mentioned in passing and noted from lab values that were "borrowed" into the multi-axial system?
Psych hospitals (regardless of independent policy and per HIPAA) are to use ICD-9 as the official reporting system. What this means is, you have to use ICD-9 guidelines for coding--regardless of the providers' use of DSM-IV in their narrative diagnostic reporting. ICD requires a condition factor in medical decision making before there can be justified inclusion for coding purposes.
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