I-10 Corner: Chapter 5 – Mental, Behavioral, and Neurodevelopmental Disorders (F01-F99)
Our next topic for the I-10 corner is the mental health chapter, Mental, Behavioral, and Neurodevelopmental Disorders. Chapter 5 is another example of the massive expansion of codes in ICD-10. I have highlighted some changes and included tips that I think are important to know for coding these conditions.
See below how the codes in this chapter are no longer grouped by psychotic, non-psychotic disorders, or mental retardation.
DID YOU KNOW?
The CMS ICD-10 website contains information on the ICD-10 MS-DRG Conversion Project. An article from CMS, “Estimating the Impact of the Transition to ICD-10 on Medicare Inpatient Hospital Payments”, lists the top 10 MS-DRGs that shift to another DRG when re-coded with ICD-10. DRG 885, Psychoses is on that list. Currently, ICD-9 cases that have 296.20, Major Depression, Single Episode, Unspecified sequenced as the principal diagnosis will group to DRG 885, Psychoses. Under ICD-10, this same diagnosis is assigned to F32.9 (also includes Depression NOS) which groups the case to DRG 881, Depressive Neuroses, a lower-weighted DRG. Interestingly, many hospitals in Alabama have DRG 885 listed in their top 10 diagnoses each year. It would be a good idea to see how this change will impact your facility.
A large classification change was made to the drug and alcohol abuse/dependence codes.
- There are codes to denote alcohol and drug “use”.
- No longer identify “Continuous” and “Episodic” in I-10
- Can code Blood Alcohol Levels as an additional code, if applicable:
Y90.0, Evidence of alcohol involvement determined by blood alcohol level
Chapter 5 Guidelines
- Physician documentation of a history of drug or alcohol dependence is coded as “in remission”.
- For psychoactive substance use, abuse and dependence:
The codes in Chapter 5 parallel the codes in DSM-IV TR (Diagnostic and Statistical Manual of Mental Disorders-4 Text Revision) in most cases….from the ICD-10-CM Coder Training Manual, 2014 Instructor’s Edition. Psychiatrists tend to document these conditions as they are listed in the codebooks, which can make mental health coding a little easier. In addition, I hope all of the information provided to you in the I-10 Corner has helped make your job a little easier.
Article by Anita Meyers
This material was compiled to share information. MMP, Inc. is not offering legal advice. Every reasonable effort has been taken to ensure the information is accurate and useful.