Mental disorders or mental illnesses represent a “psychological pattern, potentially reflected in behavior, that is generally associated with distress or disability, and which is not considered part of normal development of a person’s culture,” according to Wikipedia. In addition, mental disorders are often “defined by a combination of how a person feels, acts, thinks, or perceives.”
What we know is that these mental disorders can be “associated with particular regions or functions of the brain or rest of the nervous system, often in social context,” the Wikipedia site added. As science and medicine have advanced throughout the years, various definitions, assessment, and classification tools have been used.
Currently, the mental health profession is utilizing two different classifications for the diagnosis and treatment of mental health disorders. International Classification of Diseases 9th Revision Clinical Modification (ICD-9-CM), which is developed by the World Health Organization (WHO), and Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) developed from the American Psychiatric Association (APA).
As we move into ICD-10-CM as the replacement code set for ICD-9-CM, mental health providers are also seeing the updated DSM-V. The APA and the Centers for Disease Control and Prevention have worked together in the development of a more common structure and descriptive diagnosis between ICD-10-CM and the DSM-V.
ICD-10-CM and ICD-9-CM both contain mental and behavioral health codes in Chapter 5 of the manuals, but there has been a revision in the classification of some conditions, along with more granularity and greater detail. Specific guidelines for mental disorders have been developed for ICD-10-CM.
Until now, we did not have any guidelines available in ICD-9-CM for coding mental health disorders. However, in ICD-10-CM great improvements in the attention to and the standardization of specific guidelines for coding are available.
Visually, the comparison below is a great illustration of the advances that have been made in science and their inclusion in ICD-10-CM. In ICD-10-CM we see a lot more categories, subcategories, and codes. Clinical documentation will require greater detail in ICD-10-CM, but much of the kind of documentation needed has not changed from that of ICD-9-CM. The elements of acuity of the disease (i.e. acute or chronic), the etiology, and any associated manifestations or complications are still factored into the codes
When a patient suffers from more than one mental disorder concurrently, the physician is required to document the diagnosis and treatment of each.
290-294 Organic Psychotic Conditions
295-299 Other Psychoses
300-316 Neurotic Disorders, Personality Disorders, and Other Nonpsychotic Mental Disorders
317-319 Intellectual Disabilities
F01-F09 Mental Disorders due to known Physiological condition
F10-F19 Mental and Behavioral Disorders due to Psychoactive Substance Abuse
F20-F29 Schizophrenia, Schizotypal, Delusional, and Other Non-Mood Disorders
F30-F39 Mood [Affective Disorders
F40-F48 Anxiety, Dissociative, Stress-Related, Somatoform and Other Nonpsychotic Mental Disorders
F50-F59 Behavioral Syndrome Associated with Physiological Disturbances and Physical Factors
F60-F69 Disorders of Adult Personality and Behavior
F70-F79 Intellectual Disabilities
F80-F89 Pervasive and Specific Developmental Disorders
F90-F98 Behavioral and Emotional Disorders with Onset Usually Occurring in Childhood and Adolescence
F99 Unspecified Mental Disorder
SOURCE: Contexo Media. Best Practices for ICD-10-CMDocumentation and Compliance 2012. Salt Lake City: Contexo Media, 2012. Print.
In articles over the next several days, we will go into greater detail within each of these categories and the specific changes that have been made in each one.
- Examining ICD-10 Mental, Behavioral and Neurodevelopmental Disorders – PART 1
- Examining ICD-10 Mental, Behavioral and Neurodevelopmental Disorders – PART 2
- Examining ICD-10 Mental, Behavioral and Neurodevelopmental Disorders – PART 3
- Examining ICD-10 Mental, Behavioral and Neurodevelopmental Disorders – PART 4
- Examining ICD-10 Mental, Behavioral and Neurodevelopmental Disorders – PART 5
For more ICD-10 articles, please visit our ICD-10 Updates page.
— Compiled by former CIPROMS ICD-10 Coordinator, Angela Hickman, CPC, CEDC, AHIMA-Approved ICD-10 CM/PCS Trainer, AHIMA Ambassador. All rights reserved. For use or reprint in your blog, website, or publication, please contact us at firstname.lastname@example.org.