Behavioral Health Diagnoses Not Subject to Visit Limits for Most HMSA Plans

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1 Behavioral Health Diagnoses Not Subject to Visit Limits for Most HMSA Plans ICD Schizophrenia, disorganized type N/A Disorganized type schizophrenia, state Disorganized type schizophrenia, subchronic state N/A Disorganized type schizophrenia, chronic state N/A N/A Disorganized type schizophrenia, subchronic state Disorganized type schizophrenia, chronic state N/A Disorganized type schizophrenia, in Description F20.1 Disorganized schizophrenia Schizophrenia, catatonic type Catatonic type schizophrenia, state N/A Catatonic type schizophrenia, subchronic state N/A Catatonic type schizophrenia, chronic state N/A Catatonic type schizophrenia, subchronic state N/A Catatonic type schizophrenia, chronic state N/A Catatonic type schizophrenia, in Schizophrenia, paranoid type Paranoid type schizophrenia, state F20.2 Catatonic schizophrenia N/A Paranoid type schizophrenia, subchronic state N/A Paranoid type schizophrenia, chronic state N/A Paranoid type schizophrenia, subchronic state N/A Paranoid type schizophrenia, chronic state with acute exacerbation N/A Paranoid type schizophrenia, in F20.0 Paranoid schizophrenia 1 Behavioral Health Diagnoses Not Subject to Benefit Limits for Most HMSA Plans (updated 09/2015)

2 Schizophrenia, residual type N/A Schizophrenic disorder, residual type, Schizophrenic disorder, residual type, subchronic N/A Schizophrenic disorder, residual type, chronic N/A N/A N/A Schizophrenic disorders, residual type, subchronic Schizophrenic disorder, residual type, chronic Schizophrenic disorder, residual type, in N/A Unspecified schizophrenia, subchronic state N/A Unspecified schizophrenia, chronic state N/A Unspecified schizophrenia, subchronic state N/A Unspecified schizophrenia, chronic state with acute exacerbation N/A Unspecified schizophrenia, in Description F25.0 Schizoaffective disorder, bipolar type F25.1 Schizoaffective disorder, depressive type F25.8 Other schizoaffective disorders F25.9 Schizoaffective disorder, F20.3 Undifferentiated schizophrenia F20.9 Schizophrenia, F30.10 F30.9 Manic episode, F N/A Schizophrenia, undifferentiated type Schizoaffective disorder, Unspecified schizophrenia, state F20.5 Residual schizophrenia N/A Schizoaffective disorder, subchronic N/A Schizoaffective disorder, chronic N/A Schizoaffective disorder, subchronic with acute exacerbation F25.9 Schizoaffective disorder, N/A Schizoaffective disorder, chronic with acute exacerbation N/A Schizoaffective disorder, in F20.9 Schizophrenia, F Behavioral Health Diagnoses Not Subject to Benefit Limits for Most HMSA Plans (updated 09/2015)

3 Description severe, without mention of F30.13 Manic episode, severe, without psychotic severe, specified as with in in partial partial or in full in full N/A Manic disorder, recurrent episode, degree F30.2 Manic episode, severe with psychotic F30.3 Manic episode in partial F30.4 Manic episode in full F N/A Manic disorder, recurrent episode, degree F N/A N/A N/A N/A N/A in partial Manic disorder, recurrent episode, degree Manic disorder, recurrent episode, severe degree, without mention of F30.12 F30.13 Manic episode, severe, without psychotic Manic disorder, recurrent episode, severe Manic episode, severe with psychotic F30.2 degree, specified as with Manic disorder, recurrent episode, in partial or F30.3 Manic episode in partial Manic disorder, recurrent episode, in full F30.4 Manic episode in full F32.9 degree F32.0 degree F32.1 degree severe degree, without mention of psychotic F32.2 severe degree, specified as with psychotic F32.3 in in F32.4 partial or partial 3 Behavioral Health Diagnoses Not Subject to Benefit Limits for Most HMSA Plans (updated 09/2015)

4 in full Major depressive disorder, single episode in full degree degree severe degree, without mention of psychotic severe degree, specified as with psychotic in partial in partial or in full in full manic, manic, current) manic, manic, current) manic, manic, current) manic, severe, without mention of manic, manic, in partial manic, in full degree current) manic, current) manic, severe, specified as with current) manic, in partial or current) manic, in full F32.5 F33.40 F33.9 Description in full Major depressive disorder, recurrent, in, Major depressive disorder, recurrent, F33.0 Major depressive disorder, recurrent, F33.1 F33.2 F33.3 F33.41 F33.42 Major depressive disorder, recurrent, Major depressive disorder, recurrent severe without psychotic features Major depressive disorder, recurrent, severe with psychotic Major depressive disorder, recurrent, in partial Major depressive disorder, recurrent, in full F31.0 Bipolar disorder, current episode hypomanic F31.10 without psychotic features, F31.89 Other bipolar disorder F31.11 without psychotic features, F31.12 without psychotic features, F31.13 F31.2 F31.73 F31.74 without psychotic features, severe Bipolar disorder, in partial, most recent episode manic Bipolar disorder, in full, most recent episode manic 4 Behavioral Health Diagnoses Not Subject to Benefit Limits for Most HMSA Plans (updated 09/2015)

5 Description depressed, current) depressed, F31.30 or severity, depressed, depressed, depressed, depressed, depressed, in partial depressed, in full mixed, mixed, mixed, mixed, mixed, mixed, in partial mixed, in full current) depressed, current) depressed, current) depressed, severe, without mention of current) depressed, severe, specified as with current) depressed, in partial or current) depressed, in full current) mixed, current) mixed, current) mixed, current) mixed, severe, without mention of current) mixed, severe, specified as with current) mixed, in partial or current) mixed, in full F31.31 F31.32 F31.4 F31.5 F31.75 F31.76 F31.60 severe, without psychotic features severe, with psychotic features Bipolar disorder, in partial, most recent episode depressed Bipolar disorder, in full, most recent episode depressed F31.61 F31.62 F31.63 F31.64 F31.77 F31.78 severe, without psychotic features severe, with psychotic features Bipolar disorder, in partial, most recent episode mixed Bipolar disorder, in full, most recent episode mixed 5 Behavioral Health Diagnoses Not Subject to Benefit Limits for Most HMSA Plans (updated 09/2015)

6 296.7, current) F31.70 F31.71 F31.72 Description Bipolar disorder, currently in, most recent episode Bipolar disorder, in partial, most recent episode hypomanic Bipolar disorder, in full, most recent episode hypomanic F31.9 Bipolar disorder, Bipolar disorder NOS Bipolar disorder, F31.9 Bipolar disorder, N/A Atypical manic disorder F30.8 Other manic episodes N/A Atypical depressive disorder F32.8 Other depressive episodes Bipolar II disorder Other and bipolar disorders F31.81 Bipolar II disorder Delusional disorder Delusional disorder F22 Delusional disorders Dissociative amnesia Dissociative amnesia F44.0 Dissociative amnesia Dissociative fugue Dissociative fugue F44.1 Dissociative fugue Dissociative identity disorder Dissociative identity disorder F44.81 Dissociative identity disorder Dissociative disorder NOS Dissociative disorder or reaction, F44.9 Dissociative and conversion disorder, Obsessive-compulsive disorder Obsessive-compulsive disorders F42 Obsessive-compulsive disorder Depersonalization disorder Depersonalization disorder F48.1 Depersonalization-derealization syndrome 6 Behavioral Health Diagnoses Not Subject to Benefit Limits for Most HMSA Plans (updated 09/2015)

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