Attachment 5 Arizona s Crosswalk for DC: 0-3R, DSM-IV-TR and ICD-10-CM 1

Transcription

1 Arizona Department of Health Services/Division of Behavioral Health Services Practice Tool, Working with the Birth to Five Population Attachment 5 Arizona s Crosswalk for DC: 0-3R, DSM-IV-TR and ICD-10-CM 1 Per the ADHS/DBHS Covered Behavioral Health Services Guide, a primary diagnosis for billing inpatient services is restricted to ICD-10-CM codes through While a person may have other diagnosis codes (e.g., a V code or other ICD-10 diagnostic code outside this range), inpatient psychiatric services must indicate a valid diagnosis in the above range as primary to adjudicate successfully. The Arizona DC: 0-3R crosswalk serves strictly as a tool to assist the behavioral health provider in assigning the correct diagnostic code when working with children in the first four years of life and is referenced as a sample document. Maintenance of this document with up-to-date diagnostic codes is a T/RBHA responsibility. Clinicians are advised to exert caution when using this crosswalk as some of the DC: 0-3R diagnoses do not correlate directly with the identified DSM-IV-TR and ICD-10-CM diagnoses. Use of the DC: 0-3R is meant to enhance the clinical understanding of young children by specifically attending to the complex interaction of child, caregiving, and environmental factors that have an impact on early development. It includes descriptions of difficulties that are frequently in need of clinical attention in early childhood that are either not included in other commonly used classification systems (e.g., regulation disorders) or are described in those systems in ways that do not align well with early development (e.g., PTSD). It does not, however, include all mental health disorders that affect infants, toddlers, and preschoolers. It is intended to complement the DSM-IV-TR and ICD-10-CM classifications systems, and clinicians will need to utilize diagnoses from these manuals to describe disorders not included in the DC: 0-3R. 1 Diagnostic Classification of Mental Health and Developmental Disorders in Infancy and Early Childhood: Revised Edition (DC: 0-3R); Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision (DSM-IV-TR); the International Classification of Diseases, Ninth Revision-Clinical Modification Manual (ICD-9-CM). Revised

2 100 Posttraumatic Stress Disorder Posttraumatic Stress Disorder F43.1 Posttraumatic stress disorder F43.10 Posttraumatic stress disorder, unspecified F43.12 Posttraumatic stress disorder, chronic F43.0 Acute Stress Reaction 150 Deprivation/Maltreatment Disorder Other Relationship Disturbances (no DC: 0-3R Axis I counterpart) Reactive Attachment Disorder of Infancy or Early Childhood V61.9 Relational Problem Related to a Mental Disorder or General Medical Condition V61.20 Parent-Child Relational Problem V61.8 Sibling Relational Problem V62.81 Relational Problem Not Otherwise Specified V61.21 Neglect of Child (specify if focus of clinical attention is on the victim) V61.21 Sexual Abuse of Child (specify if focus of clinical attention is on the victim) F94.1 Reactive attachment disorder of childhood F98.8 Other specified behavioral and emotional disorder with onset occurring in childhood and adolescence T74.92XA Unspecified child maltreatment, confirmed, initial encounter T76.92XA Unspecified child maltreatment, suspected, initial encounter T74.02XA Child neglect or abandonment, confirmed, initial encounter T7602.XA Child neglect or abandonment, suspected, initial encounter Revised

3 V61.21 Physical Abuse of Child (specify if focus of clinical attention is on the victim) T74.22XA Child sexual abuse, confirmed initial encounter T76.22XA Child sexual abuse, suspected, initial encounter T74.12XA Child physical abuse, confirmed, initial encounter T76.12XA Child physical abuse, suspected, initial encounter 200 Disorders of Affect 210 Prolonged Bereavement/Grief Reaction V62.82 Bereavement F43.21 Adjustment disorder with depressed mood 220 Anxiety Disorders of Infancy and Early Childhood 221 Separation Anxiety Separation Anxiety Disorder, early onset F93.0 Separation anxiety disorder of childhood Disorder 222 Specific Phobia Specific Phobia F40.8 Other phobic anxiety disorders 223 Social Anxiety Disorder Social Phobia F40.10 Social phobia, unspecified (Social Phobia) 224 Generalized Anxiety Generalized Anxiety Disorder F41.1 Generalized anxiety disorder Disorder 225 Anxiety Disorder NOS Anxiety Disorder NOS F41.9 Anxiety order, unspecified Revised

4 230 Depression of Infancy and Early Childhood 231 Type I: Major Depression 296.2x Major Depressive Disorder, Single Episode (fifth digit must be inserted): Unspecified Mild Moderate Severe without psychotic features In partial remission In full remission 232 Type II: Depressive Disorder NOS 296.3x Major Depressive Disorder, Recurrent Episode (fifth digit must be inserted): Unspecified Mild Moderate Severe In partial remission In full remission F32.9 Major depressive disorder, single episode, unspecified F32.0 Mild F32.1 Moderate F32.2 Severe, without mention of psychotic behavior F32.4 In partial or unspecified remission F32.5 In full remission F33.9 Major depressive disorder, recurrent episode (): F33.0 Mild F33.1 Moderate F33.2 Severe, without mention of psychotic behavior F33.41 In partial or unspecified remission F33.42 In full remission 311 Depressive Disorder NOS F32.9 Major depressive disorder, single episode, unspecified 240 Mixed Disorder of Mood Disorder NOS F39 Unspecified mood [affective] disorder Emotional Expressiveness 300 Adjustment Disorder Adjustment Disorder with Depressed Mood F43.21 Adjustment disorder with depressed mood Adjustment Disorder with Anxiety F43.22 Adjustment disorder with anxiety Revised

5 Adjustment Disorder with Mixed F43.23 Adjustment disorder with mixed anxiety and Anxiety and Depressed Mood depressed mood Adjustment Disorder with Disturbance of Conduct Adjustment Disorder with Mixed Disturbance of Emotions and Conduct Adjustment Disorder Unspecified V.62.4 Acculturation Problem F43.24 Adjustment disorder with disturbance of conduct F43.25 Adjustment disorder with mixed disturbance of emotions and conduct F43.20 Unspecified adjustment reaction F43.8 Other reactions to severe stress 400 Regulation Disorders of Sensory Processing 410 Hypersensitive 411 Hypersensitive Type A: Fearful/Cautious 412 Hypersensitive Type B: Negative/Defiant 420 Hyposensitive/Underresponsive Disorder of Infancy, Childhood, or Adolescence NOS Anxiety disorder NOS Disruptive Behavior Disorder NOS Disorder of Infancy, Childhood, or Adolescence NOS Disruptive Behavior Disorder NOS Disorder of Infancy, Childhood, or Adolescence NOS F93.9 Childhood emotional disorder, unspecified F41.9 Anxiety disorder, unspecified F91.1 Conduct disorder, unspecified F93.9 Childhood emotional disorder, unspecified F91.9 Conduct disorder, unspecified F93.9 Childhood emotional disorder, unspecified Revised

6 430 Sensory Stimulation Disorder of Infancy, Childhood, or F93.9 Childhood emotional disorder, unspecified Seeking/Impulsive Adolescence NOS Attention-Deficit/Hyperactivity Disorder, Combined Type or Predominately Hyperactive-Impulsive Type Impulse-Control Disorder NOS Attention-Deficit/Hyperactivity Disorder NOS Disruptive Behavior Disorder NOS 500 Sleep Behavior Disorder (Refer to the DSM-IV-TR for other sleep disorders that aren t described in the DC: 0-3R.) 510 Sleep-Onset Disorder Primary Insomnia [Indicate Axis I or Axis (Sleep-Onset Protodyssomnia) II disorder] Insomnia Related to 520 Night-Waking Disorder (Night-Waking Protodyssomnia) Circadian Rhythm Sleep Disorder Sleep Terror Disorder Sleepwalking Disorder Dyssomnia NOS, Nightmare Disorder, or Parasomnia NOS F90.1 Attention deficit disorder, predominately hyperactive type F63.9 Impulse disorder, unspecified F90.9 Attention-deficit hyperactivity disorder, unspecified type F91.9 Conduct disorder, unspecified F51.04 Psychophysiologic insomnia F51.01 Primary insomnia F51.8 Other sleep disorders not due to a substance or known physiological condition G47.21 Circadian rhythm sleep disorder, delayed sleep phase type F51.9 Sleep disorder not due to a substance or known physiological condition, unspecified F41.02 Adjustment insomnia F51.3 Sleepwalking [somnambulism] F51.8 Other sleep disorders not due to a substance or known physiological condition Revised

7 Primary Insomnia F51.01 Primary insomnia Circadian Rhythm Sleep Disorder F51.9 Sleep disorder not due to a substance or known physiological condition, unspecified F51.02 Adjustment insomnia F51.8 Other sleep disorders not due to a substance or known physiological condition 600 Feeding Behavior Disorder 601 Feeding Disorder of State Regulation 602 Feeding Disorder of Caregiver-Infant Reciprocity 603 Infantile Anorexia 604 Sensory Food Aversions 605 Feeding Disorder Associated with Concurrent Medical Condition 606 Feeding Disorder Associated with Insults to the Gastrointestinal Tract 700 Disorders of relating and communicating 710 Multisystem Developmental Disorder (MSDD) for children under the age of two years; pervasive Feeding Disorder of Infancy or Early Childhood Autistic Disorder Pervasive Developmental Disorder NOS F50.8 Other eating disorders R63.3 Feeding difficulties P92.9 Feeding problems of newborn, unspecified F84.0 Autistic disorder F84.5 Asperger s syndrome F84.9 Unspecified pervasive developmental disorder Revised

8 developmental disorders can be utilized for children over the age of two if identified 800 Other Disorders (DSM-IV- TR or ICD-10-CM) This coding is to be used for other mental health-related classifications not found in the DC: 0-3R that are present in the DSM-IV-TR or ICD-10-CM. Medical diagnoses and major developmental disabilities are to be listed under Axis III on the DC: 0-3R and relationship classifications under Axis II. F89 Unspecified disorder of psychological development F81.9 Developmental disorder of scholastic skills, unspecified Note: If no other DC: 0-3R or DSM-IV-TR Diagnostic Code clearly fits at the time of assessment, clinicians can default to the use of the DSM-IV-TR Code Disorder of Infancy, Childhood, or Adolescence NOS until a more clearly identified diagnosis can be determined. Revised