ICD-10-CM code discrepancies found in DSM-5
DSM-5 users should print out “Coding Updates for DSM-5” for corrections from the American Psychiatric Association’s DSM-5 Implementation and Support page.
The American Psychiatric Association identified some errors and discrepancies in the print edition of the DSM-5 which contains both ICD-9-CM and ICD-10-CM codes. The American Psychiatric Association released a “Coding Updates for DSM-5” document to address these issues. DSM-5 users should print out “Coding Updates for DSM-5” for corrections from the American Psychiatric Association’s DSM-5 Implementation and Support page. Note that this site works best with Google Chrome or Mozilla Firefox.
Notably, the ICD-10-CM codes for Trichotillomania and Kleptomania have been transposed. Trichotillomania should be F63.3 and Kleptomania should be F63.2
The coding update also changes recommendations for ICD-10-CM codes for several of the Major Neurocognitve Disorder diagnoses when the specifier “with behavioral disturbance” is used. The update recommends that codes from Chapter 5, Mental, Behavioral and Neurodevelopmental disorders (F codes) be used instead of the originally recommended codes from Chapter 6, Diseases of the nervous system (G codes). The American Psychiatric Association explains that it made this change for consistency with how insurance companies categorize and cover these disorders.
In general, psychologists, psychiatrists and other mental health professionals will face less scrutiny from payers when the primary diagnostic code “matches” the Current Procedural Terminology (CPT®) code. In other words, behavioral health diagnoses assigned with behavioral health services. Of course, all codes assigned should accurately reflect the diagnostic picture and services provided.
Lastly, DSM-5 users who have taken the time to become directly familiar with the ICD-10-CM may disagree with some recommended ICD-10 codes. For instance, DSM-5 uses F40.10 for Social Anxiety Disorder which maps to “Social Phobia, Unspecified” in the ICD-10-CM. Social phobia, generalized is coded as F40.11, which may be a more appropriate diagnostic code for different presentations. Also, for schizophrenia, the DSM-5 uses ICD-10-CM code F20.9, which crosswalks to schizophrenia, unspecified. Some psychologists may prefer F20.0 for paranoid schizophrenia, or F20.3 for undifferentiated schizophrenia rather than the one code identified in the DSM-5.
Psychologists are encouraged to download the most current version of the ICD-10-CM and cross check their most frequently used diagnoses and codes with the official code set. To download the ICD-10-CM, visit the Centers for Disease Control and Prevention website and go to "FY 2016 release of ICD-10-CM" section. Select ICD-10-CM PDF format to access a PDF version of the document. It directs you to an index of compressed zip files. Within that index, select ICD10CM_FY2016_Full_PDF.ZIP. This zip folder contains five files. Open the final file labeled 'Tabular.'
Current Procedural Terminology (CPT®) copyright 2016 American Medical Association. All rights reserved.