by Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
June 17th, 2015
Both DSM-5 and ICD-9 codes are used for diagnosis and are exactly the same codes. For reporting purposes it is required to report ICD-9 codes to insurance payers. Most payers require ICD-9 codes to be billed on electronic or paper claims. Therefore, the codes are the same in DSM as in ICD-9, however keep in mind the descriptions may be different.
DSM uses a different pathway directing them to the code used for billing. DSM endorses most Behavioral health ICD-9 codes, however some ICD-9 codes are excluded in DSM-5.
The most important aspect of using DSM and ICD-9 is that the diagnosis supports the treatment and is medically necessary.
Everyone will be required to report diagnosis codes using ICD-10 starting October 2015.
Example:
DSM-IV
290.0 - dementia of the Alzheimer's type, with late onset, uncomplicated
290.10 - dementia due to Creutzfeldt -Jakob disease dementia due to Pick's disease dementia of the Alzheimer's type, with early onset, uncomplicated
ICD-9-CM
290.0 - senile dementia, uncomplicated
290.1 - presenile dementia
290.10 - presenile dementia, uncomplicated
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