AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2020 Issue 1; Ask the Editor
Psychoactive Substance Use and Physical Disorder
The Official Guidelines for Coding and Reporting for Psychoactive Substance Use, Unspecified (I.C.5.b.3.) state, “These codes are to be used only when the psychoactive substance use is associated with a physical, mental or behavioral disorder, and such a relationship is documented by the provider.” Coding professionals are unclear as to what constitutes a “physical disorder.” What does the term “physical” in guideline I.C.5.b.3 mean? ...
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Article Overview
This article reviews an ICD-10-CM guideline issue related to psychoactive substance use and the addition of the term “physical” in the unspecified-use guidance. It is aimed at coding professionals who need to understand the scope of the revised language and the general kinds of conditions it was intended to capture within chapter 5. The discussion is centered on reporting guidance, the related guideline section, and the broader distinction between mental and non-mental conditions.
Why This Topic Matters
Understanding this clarification helps coding professionals interpret the scope of the ICD-10-CM guidance correctly and recognize when the guideline applies to documented relationships between substance use and associated disorders.
What You Will Learn
- The ICD-10-CM guideline context for psychoactive substance use, unspecified
- How the term “physical” is discussed in relation to the guideline
- Why the October 1, 2018 revision is relevant to coding guidance
- The general distinction between mental disorders and other chapter 5 conditions
Who Should Read This
- Coding professionals
- ICD-10-CM coders
- Clinical documentation review staff
- Revenue cycle teams
Code Ranges Discussed
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