The Transition from DSM-5 to ICD-10 on Oct. 1st, 2015

Clinical Update August 2015

By Zur Institute

View a complete list of Clinical Updates.

DSM 5 to ICD 10

No need to stress:

The transition to ICD-10-CM is important and ‘doable’
 

Here are some tips ~
  • Yes, the transition from DSM-5 and ICD-9 to ICD-10 (ICD-10-CM) will take place in a couple of months on October 1st, 2015.
  • No, it is not a huge deal. You do not need to worry too much nor get overly anxious about it.
  • Yes, the ICD-10 diagnosis codes are available in the current DSM-5. They are noted in parentheses, in gray and start with a letter. The codes are also available on online sites.
  • No, the upcoming transition to ICD-10 will not effect the CPT codes that therapists use in their insurance billing.
  • Yes, starting Oct. 1st therapists who do insurance billing will be required to use the ICD-10 diagnoses in the coding they submit to insurance companies or in the statements they give to their clients.
  • No, you do not need to change your fees or the length of your sessions. You only need to use a new diagnostic code in your billing.
  • No, do not bill for the periods before and after Oct. 1st on the same insurance invoice.
  • Yes, use separate invoices for each time period:
    • Use ICD-9 or DSM-5 for sessions prior to Oct. 1st
    • ICD-10 for any sessions on Oct. 1st and thereafter.
  • No, the actual DSM diagnoses and criteria will not change in the ICD-10, only the diagnostic codes and perhaps the level of specificity.
  • Yes, the ICD-10 is much more specific than the ICD-9, it includes 69,844 codes, compared to 15,400 in the ICD-9. The ICD-10 is more robust, includes new disorders, and is more specific.
  • No, you will not get reimbursed by insurance unless you use the ICD-10 codes in your insurance billings after Oct. 1st.
  • Yes, you better be as specific as you can in your dx. ICD-10 includes a more specific range of diagnosis than most of us are accustomed to.
  • No, not all diagnostic codes have the same number of digits. ICD-10 uses 3 to 7 alpha and numeric characters. You must use all the applied characters.
  • Yes, therapists are most likely to use Chapter 5 in the ICD-10 where codes begin with the letter F.
  • Finally, there are a lot of excellent and helpful resources online, here are a few: