Covered Diagnoses & Crosswalk of DSM-IV Codes to ICD-9-CM Codes

Transcription

1 Covered Diagnoses & Crosswalk of DSM-IV Codes to ICD-9-CM Codes What is the crosswalk? The crosswalk is a document designed to help you determine which ICD-9-CM diagnosis code corresponds to a particular DSM-IV-TR diagnosis code. Do I need to use it? Under the Health Insurance Portability and Accessibility Act (HIPAA), insurance companies who accept and process insurance claims electronically are only required to accept ICD-9-CM diagnosis codes. Because there is no HIPAA requirement that insurance companies also accept DSM-IV-TR codes, insurance companies are likely to only accept electronic claims that use ICD-9-CM diagnosis codes, and which will require psychologists who are only familiar with DSM-IV-TR to convert their DSM-IVTR diagnosis codes into ICD-9-CM diagnosis codes. If your insurance company requires you to submit paper or electronic claims using only ICD-9- CM diagnosis codes, and you are only familiar with DSM-IV-TR diagnosis codes, then you will need to use this crosswalk to convert your DSM-IV-TR diagnosis code(s) into ICD-9-CM diagnosis codes. How does it work? The DSM-IV-TR codes and descriptions are provided in the columns on the left side of the page; the corresponding ICD-9-CM diagnosis code and ICD-9-CM diagnosis description are provided in the columns on the right side of the page. Find the appropriate DSM-IV-TR code, and follow the table across to find the corresponding ICD-9-CM code. In many cases but not all the ICD-9-CM code and description will be identical to the DSM-IV-TR code. If you have any feedback on this document, or have questions about the content, please contact us at PracGovt@apa.org. DSM-IV Description type, with late onset, uncomplicated dementia due to Creutzfeldt- Jakob disease dementia due to Pick's disease type, with early onset, uncomplicated ICD-9-CM Description senile dementia, uncomplicated presenile dementia presenile dementia, uncomplicated

2 type, with early onset, with delirium type, with early onset, with delusions type, with early onset, with depressed mood type, with late onset, with delusions type, with late onset, with depressed mood type, with late onset, with delirium vascular dementia, uncomplicated vascular dementia, with delirium vascular dementia, with delusions vascular dementia, with depressed mood delirium due to...[general medical condition] psychotic due to.. [general medical condition], with delusions Hallucinations presenile dementia with delirium presenile dementia with delusional features presenile dementia with depressive features senile dementia with delusional or depressive features senile dementia with delusional features senile dementia with depressive features senile dementia with delirium arteriosclerotic dementia arteriosclerotic dementia, uncomplicated arteriosclerotic dementia with delirium arteriosclerotic dementia with delusional features arteriosclerotic dementia with depressive features other specified senile psychotic conditions senile psychotic condition transient organic psychotic 293 conditions acute delirium subacute delirium other specified transient organic mental s organic delusional syndrome organic hallucinosis syndrome

3 mood due to [general medical condition] anxiety due to [general medical condition] catatonic due to [general medical condition] mental NOS due to...[general medical condition] amnestic due to...[general medical condition] dementia due to...[general medical condition] organic affective syndrome other transient organic mental other organic psychotic conditions (chronic) amnestic syndrome dementia in conditions classified elsewhere amnestic NOS other specified organic brain syndromes (chronic) dementia NOS cognitive NOS organic brain syndrome (chronic) dementia due to HIV disease 295 schizophrenic s (there is a 5th-digit subclass.) simple type schizophrenia, disorganized disorganized type schizophrenia, catatonic type catatonic type schizophrenia, paranoid type paranoid type schizophreniform acute schizophrenic episode latent schizophrenia schizophrenia, residual type residual schizophrenia schizoaffective schizo-affective type other specified types of schizophrenia schizophrenia, undifferentiated type schizophrenia

4 296 bipolar s (same 5 th digit subclass for ) affective psychoses (5th-digit subclass for : 0- ; 1-mild; 2- moderate; 3-severe, without mention of psychotic behavior; 4-severe, specified as with psychotic behavior; 5-in partial or remission; 6-in full remission) manic, single episode manic, recurrent episode major depressive, single episode major depressive, recurrent episode bipolar affective, manic major depressive, single episode major depressive, recurrent bipolar I, most recent episode hypomanic bipolar I, most recent episode manic bipolar I, most bipolar affective, recent episode depressed depressed bipolar I, most bipolar affective, recent episode mixed mixed bipolar I, most bipolar affective, recent episode manic-depressive psychosis, other and bipolar NOS manic-depressive psychosis, atypical manic atypical depressive bipolar II Other other and affective psychoses mood NOS affective psychosis other specified affective psychoses 297 paranoid states paranoid state, simple delusional paranoia paraphrenia shared psychotic shared paranoid

5 297.8 other specified paranoid states paranoid state 298 other nonorganic psychoses depressive type psychosis excitative type psychosis reactive confusion acute paranoid reaction psychogenic paranoid psychosis brief psychotic other and reactive psychosis psychotic NOS psychosis 299 psychoses with origin specific to childhood (5th-digit class.) autistic infantile autism childhood disintegrative disintegrative psychosis Asperger's other specified early childhood psychoses pervasive developmental NOS Rett s neurotic s anxiety states anxiety NOS anxiety state, panic without panic agoraphobia generalized anxiety generalized anxiety other hysteria hysteria, conversion conversion dissociative amnesia psychogenic amnesia dissociative fugue psychogenic fugue dissociative identity multiple personality dissociative NOS dissociative or reaction, factitious with predominantly psychological signs and symptoms factitious illness with psychological symptoms factitious NOS factitious illness

6 factitious with combined psychological and physical signs and symptoms factitious with predominantly physical signs and symptoms phobic s phobia, panic with agoraphobia with panic agoraphobia attacks agoraphobia without history agoraphobia without mention of panic of panic attacks social phobia social phobia specific phobia other isolated or simple phobias obsessive-compulsive obsessive-compulsive s dysthymic neurotic depression neurasthenia depersonalization depersonalization syndrome body dysmorphic hypochondriasis hypochondriasis other neurotic s somatization somatization somatization NOS undifferentiated somatoform other mental (nonpsychotic) neurotic 301 personality s paranoid personality paranoid personality affective personality affective personality, chronic hypomanic personality chronic depressive personality cyclothymic cyclothymic schizoid personality schizoid personality schizoid personality, introverted personality

7 schizotypal personality schizotypal personality explosive personality obsessive-compulsive personality Compulsive personality histrionic personality histrionic personality histrionic personality, chronic factitious illness with physical symptoms other histrionic personality dependent personality dependent personality antisocial personality antisocial personality other personality s narcissistic personality narcissistic personality avoidant personality avoidant personality borderline personality borderline personality passive-aggressive personality other personality NOS personality 302 sexual deviations and s Pedophilia pedophilia Exhibitionism Exhibitionism gender identity s of psychosexual in children identity gender identity NOS sexual sadism sexual sadism gender identity in gender identity of adolescents or adults adolescent or adult life Frotteurism Other 306 physiological malfunctions arising from mental factors musculoskeletal respiratory cardiovascular skin gastrointestinal genitourinary

8 psychogenic genitourinary malfunction, vaginismus (not due to general medical condition) psychogenic vaginismus psychogenic dysmenorrhea psychogenic dysuria other endocrine organs of special sense other specified psychophysiological malfunction psychophysiological malfunction 307 special symptoms or syndromes, not elsewhere classified anorexia nervosa anorexia nervosa tics tic NOS tic, transient tic transient tic of childhood chronic motor or vocal tic chronic motor tic Tourette's Gilles de la Tourette's stereotypic movement stereotyped repetitive movements sleep terror somnambulism or night terrors sleepwalking other and s of eating eating NOS eating, bulimia nervosa bulimia Pica pica rumination psychogenic rumination psychogenic vomiting feeding of infancy or early childhood Other enuresis [not due to a general medical condition] enuresis

9 encopresis, without constipation and overflow incontinence pain associated with psychological factors pain associated with both psychological factors and a general medical condition encopresis psychalgia psychogenic pain, site other communication NOS other and special symptoms or syndromes, not elsewhere classified 308 acute reaction to stress predominant disturbance of emotions predominant disturbance of consciousness predominant psychomotor disturbance acute stress other acute reactions to stress mixed s as reaction to stress acute reaction to stress 309 adjustment reaction adjustment with depressed mood brief depressive reaction prolonged depressive reaction with predominant disturbance of other emotions separation anxiety separation anxiety emancipation of adolescence and early and adult life specific academic or work inhibition adjustment with adjustment reaction with anxiety anxious mood adjustment with mixed anxiety and depressed mood other adjustment reaction with mixed emotional features

10 309.3 adjustment with with predominant disturbance of conduct disturbance of conduct adjustment with with mixed disturbance of mixed disturbance of emotions emotions and conduct and conduct other specified adjustment reactions posttraumatic stress prolonged posttraumatic stress adjustment reaction with physical symptoms adjustment reaction with withdrawal other adjustment adjustment reaction specific nonpsychotic mental 310 s due to organic brain damage frontal lobe syndrome personality change due to [indicate the general medical organic personality syndrome condition] postconcussion syndrome other specified nonpsychotic mental s following organic brain damage nonpsychotic mental following organic brain damage 311 depressive NOS 311 depressive, not elsewhere classified disturbance of conduct, not 312 elsewhere classified (5th digit class. used) undersocialized conduct, aggressive type undersocialized conduct, unaggressive type socialized conduct s of impulse control, not elsewhere classified impulse-control NOS impulse control, Kleptomania kleptomania Pyromania pyromania

11 intermittent explosive intermittent explosive isolated explosive Trichotillomania other mixed disturbance of conduct and emotions conduct other specified disturbances of conduct, not elsewhere classified disruptive behavior disturbance of conduct 313 disturbance of emotions specific to childhood and adolescence overanxious misery and unhappiness sensitivity, shyness, and social withdrawal shyness of childhood introverted of childhood selective mutism elective mutism relationship problems emotional disturbancees of childhood or adolescence oppositional defiant oppositional Identity problem Identity academic underachievement reactive attachment of infancy or early childhood other of infancy, emotional disturbance of childhood, or adolescence childhood or adolescence NOS 314 hyperkinetic syndrome of childhood attention deficit attention-deficit/hyperactivity, predominantly inattentive type attention-deficit/hyperactivity, combined type without mention of hyperactivity with hyperactivity

12 attention-deficit/hyperactivity, predominantly hyperactive-impulsive type attention-deficit/hyperactivity NOS [specified psychological factor] affecting...[indicate the general medical condition] hyperkinesis with developmental delay hyperkinetic conduct other specified manifestations of hyperkinetic syndrome hyperkinetic syndrome 316 psychic factors associated with diseases classified elsewhere