Provider Notice May 30, Pre-Authorization 1915(b) Service
|
|
- Emma Shepherd
- 7 years ago
- Views:
Transcription
1 Provider Notice 1.13 May 30, 2008»» Pre-Authorization 1915(b) Service 1915(b) Attendant Care Services (CPT T1019HE) and 1915(b) Case Conference services (CPT 99366, 99367, 99368) are pre-authorized services and authorization must be obtained prior to rendering these services. These services have limited funding available and a review of the level of authorized services in our first year indicated that if fully utilized, we would exceed available funds. Additionally, authorizations for these services are tied to the member s benefit year which will end on June 30th. Because of these issues, KHS is making changes in the 1915(b) pre-authorization process. Authorization for continued services must be obtained beginning with the new benefit year, starting July 1, To assist with the transition into year 2, KHS has established the following steps for pre-authorized services only. These procedures do not apply to SED Waiver or PRTF Waiver Services. 1. Effective July 1, 2008, requests for new authorizations will not be granted retro-active. These services must be authorized prior to service delivery or claims will be denied. 2. Because these services have limited funding and KHS wanted to manage the available funds to ensure all members receive medically necessary services, new authorizations will be limited to 1,000 units of Attendant Care and 16 units of Case Conference. 3. If members require additional services beyond the 1,000 unit limit for Attendant Care, an exception may be requested through Care Management, and if approved, additional services will be authorized. Exceptions will not be granted to exceed the 16 unit limit for Case Conference. 4. Existing authorizations will end on June 30, 2008 as part of member benefit year. 5. Member registrations which were scheduled to expire on June 25th and where Providers received worksheets requiring new authorization and medical necessity justification will be granted 1,000 units of Attendant Care and 16 units of Case Conference per member upon return of completed worksheets, effective July 1, Existing authorizations that would have continued beyond July 1, 2008 will be zeroed out and a new one-time authorization will be granted for 500 units of Attendant Care and 16 units of Case Conference, effective July 1, Providers will be required to update the medical necessity justification for Attendant Care in the authorization request on Provider Connect before September 30, 2008 or these authorizations will expire. 7. If a members KHS eligibility is issued retroactive, contact Care Management for authorization of these services. Once auth 8. orization for these two services is granted, the authorization number is not required to be placed on the claim. Changes will go into effect 30 days following the date of publication of Provider Notice. Page 1 of 5
2 »» Psychiatric Diagnostic Interview Exams ( CPT 90801) Effective July 1, 2008 KHS will pay for the diagnostic interview examinations (intakes) under the following conditions: When billed with place of service 21 (Acute Inpatient Hospital) by participating Physician, PA or ARNP. When billed with place of service 51 (Non-state Inpatient Psychiatric Facility) by participating Physician, PA or ARNP. When billed with a recognized Outpatient place of service by a participating LMHP, Physician, PA or ARNP.»» Psychological Testing Reminders All Providers are remained that certain psychological testing codes have unit values of one HOUR and some are performed PER SESSION. Psychological testing (96101 & 96102) and Neuropsychological testing (96118 & 96119) are hourly codes and must be billed as 1 unit = 1 hour. Psychological testing and Neuropsychological testing by computer are billed as per session and must be billed as 1 unit = the entire length of the session. Steve Richards Chief Financial Officer»» Kansas Health Solutions Covered Diagnoses Dementia of the Alzheimer s Type, With Early Onset, With Delusions Dementia of the Alzheimer s Type, With Early Onset, With Depressed Mood Dementia of the Alzheimer s Type, With Late Onset, With Delusions Dementia of the Alzheimer s Type, With Late Onset, With Depressed Mood Vascular Dementia, With Delusions Vascular Dementia, With Depressed Mood Cognitive Disorder NOS Schizophrenia, Disorganized Type Schizophrenia, Catatonic Type Schizophrenia, Paranoid Type Schizophreniform Disorder Schizophrenia, Residual Type Schizoaffective Disorder Schizophrenia Undifferentiated Type 296.0x Bipolar I Disorder Single Manic Episode 296.2x Major Depressive Disorder Single Episode 296.3x Major Depressive Disorder Recurrent Bipolar I Disorder Most Recent Episode Hypo manic Provider Notice 1.13 Page 2 of 5
3 296.4x Bipolar I Disorder Most Recent Episode Manic 296.5x Bipolar I Disorder Most Recent Episode Depressed 296.6x Bipolar I Disorder Most Recent Episode Mixed Bipolar I Disorder, Most recent episode Unspecified Bipolar Disorder NOS Bipolar II Disorder Mood Disorder NOS Delusional Disorder Shared Psychotic Disorder Brief Psychotic Disorder Psychotic Disorder NOS Rett s Disorder Asperger s Disorder Anxiety Disorder NOS Panic Disorder Without Agoraphobia Generalized Anxiety Disorder Conversion Disorder Dissociative Amnesia Dissociative Fugue Dissociative Identity Disorder Dissociative Disorder NOS Factitious Disorder With Predominantly Psychological Signs and Symptoms Factitious Disorder NOS Factitious Disorder With Combined Psychological and Physical Signs and Symptoms Factitious Disorder With Predominantly Physical Signs and Symptoms Panic Disorder With Agoraphobia Agoraphobia Without History of Panic Disorder Social Phobia Specific Phobia Obsessive-Compulsive Disorder Dysthymic Disorder Depersonalization Disorder Body Dysmorphic Disorder Hypochondriasis Somatization Disorder Undifferentiated Somatoform Disorder Somatoform Disorder NOS Unspecified Mental Disorder (nonpsychotic) Paranoid Personality Disorder Cyclothymic Disorder Schizoid Personality Disorder Schizotypal Personality Disorder Obsessive-Compulsive Personality Disorder Provider Notice 1.13 Page 3 of 5
4 Histrionic Personality Disorder Dependent Personality Disorder Antisocial Personality Disorder Narcissistic Personality Disorder Avoidant Personality Disorder Borderline Personality Disorder Personality Disorder NOS Pedophilia Transvestic Fetishism Exhibitionism Gender Identity Disorder NOS Gender Identity Disorder in Children or Gender Identity Disorder NOS Sexual Dysfunction NOS Hypoactive Sexual Desire Disorder Female Sexual Arousal Disorder Male Erectile Disorder Female Orgasmic Disorder Male Orgasmic Disorder Premature Ejaculation Dyspareunia (Not Due to a General Medical Condition) Sexual Aversion Disorder Fetishism Voyeurism Sexual Masochism Sexual Sadism Gender Identity Disorder in Adolescents or Adults Frotteurism Sexual Disorder NOS Paraphilia NOS Vaginismus (Not Due to a General Medical Condition) Stuttering Anorexia Nervosa Tic Disorder NOS Transient Tic Disorder Chronic Motor or Vocal Tic Disorder Tourette s Disorder Stereotypic Movement Disorder Primary Insomnia Primary Hypersomnia Sleep Terror Disorder Sleepwalking Disorder Dyssomnia NOS Provider Notice 1.13 Page 4 of 5
5 Nightmare Disorder Parasomnia NOS Eating Disorder NOS Bulimia Nervosa Pica Rumination Disorder Enuresis (Not Due to a General Medical Condition) Encopresis Without Constipation and Overflow Incontinence Pain Disorder Associated With Psychological Factors Pain Disorder Associated With Both Psychological Factors and a General Medical Condition Acute Stress Disorder Adjustment Disorder With Depressed Mood Separation Anxiety Disorder Adjustment Disorder With Anxiety Adjustment Disorder With Mixed Anxiety and Depressed Mood Adjustment Disorder With Disturbance of Conduct Adjustment Disorder With Mixed Disturbance of Emotions and Conduct Posttraumatic Stress Disorder Adjustment Disorder Unspecified Personality Change Due to General Medical Condition 311 Depressive Disorder NOS Impulse-Control Disorder NOS Pathological Gambling Kleptomania Pyromania Intermittent Explosive Disorder Trichotillomania Conduct Disorder, Childhood-Onset Type Conduct Disorder, Adolescent-Onset Type Conduct Disorder, Unspecified Onset Disruptive Behavior Disorder NOS Selective Mutism Oppositional Defiant Disorder Reactive Attachment Disorder of Infancy or Early Childhood Attention-Deficit/Hyperactivity Disorder Predominantly Inattentive Type Attention-Deficit/Hyperactivity Disorder Combined Type Attention-Deficit/Hyperactivity Disorder Predominantly hyperactive-impulsive Type Attention-Deficit/Hyperactivity Disorder NOS Neglect of child- clinical attention on victim Sexual Abuse of child- clinical attention on victim Physical Abuse of child- clinical attention on victim Carol Neeley Clinical Director Provider Notice 1.13 Page 5 of SW Jackson, Suite 310 Topeka, KS toll free fax
Complete List of DSM-IV Codes
Complete List of DSM-IV Codes The following 2 tables give basic codes for all DSM-IV diagnoses. Note that the numbers are the least important part of the diagnoses: Additional verbiage, often not stated
More informationDSM IV TR Diagnostic Codes. (In Numeric Order) DSM IV Codes: Through revisions on 10.01.1996 and 10.01.2005. Code Description Code Description
290.0 Dementia of the Alzheimer's type, with late onset, uncomplicated NO DSM IV TR 290 code / See codes [294.10 294.1x] 290.10A Dementia due to Creutzfeldt Jakob disease NO DSM IV TR 290.10 code / See
More informationIL DHS/DMH DSM 5 Diagnoses Effective 10-1-2015 Target Population: Serious Mental Illness (SMI) for DHS/DMH funded MH services
IL DHS/DMH DSM 5 Diagnoses Effective 10-1-2015 Target Population: Serious Mental Illness (SMI) for DHS/DMH funded MH services ICD-10 DSM-V Description F22 Delusional Disorder F23 Brief Psychotic Disorder
More informationICD-9/DSM IV TO ICD-10 CROSSWALK TABLE
ICD-9/DSM IV TO ICD-10 CROSSWALK TABLE DIAGNOSIS MEETS OUTPATIENT "MEDICAL NECESSITY" CRITERIA ICD-9 DSM IV Description ICD-10 ICD-10 Description PSYCHOTIC DISORDERS 295.30 Schizophrenia, Paranoid Type
More informationMental Health ICD-10 Codes Department of Health and Mental Hygiene
Mental Health ICD-10 Codes Department of Health and Mental Hygiene (2) For dates of service on or after October 1, 2015: F200 F201 F202 F203 F205 F2081 F2089 F209 F21 F22 F23 F24 F250 F251 F258 F259 F28
More informationSpecialty Mental Health Services OUTPATIENT TABLE
Specialty Mental Health Services Enclosure 3 295.10 Schizophrenia, Disorganized Type F20.1 Disorganized schizophrenia 295.20 Schizophrenia, Catatonic Type F20.2 Catatonic schizophrenia 295.30 Schizophrenia,
More informationICD-10 Mental Health Billable Diagnosis Codes in Alphabetical Order by Description
Mental Health Billable s in Alphabetical Order by Note: SSIS stores code descriptions up to 100 characters. Actual code description can be longer than 100 characters. F40.241 Acrophobia F43.0 Acute stress
More informationCare Management Scale--Youth Rev. 10/26/07
Care Management Scale--Youth Rev. 10/26/07 Client Name: ID: Date: _ Person Completing: Chronicity: Client has a qualifying diagnosis (see attached list) Mental Health condition was first documented to
More informationCovered Diagnoses & Crosswalk of DSM-IV Codes to ICD-9-CM Codes
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
More informationDiagnosis Codes Requiring PASRR Level II_011.22.11.xls
291.0 DELIRIUM TREMENS ALCOHOL WITHDRAWAL DELIRIUM Mental Illness 291.1 ALCOHOL AMNESTIC DISORDEALCOHOL INDUCED PERSISTING AMNESTIC DISORDER Mental Illness 291.2 ALCOHOLIC DEMENTIA NEC ALCOHOL INDUCED
More informationAttachment A. Code Beginning Review
Attachment A ICD-10-CM Mental Disorders Diagnosis Codes and s Subject to Certification of Admission/Concurrent/Continued Stay Review Based on the Admitting Diagnosis Code This list contains principal diagnosis
More informationDSM-5 to ICD-9 Crosswalk for Psychiatric Disorders
DSM-5 to ICD-9 Crosswalk for Psychiatric s The crosswalk found on the pages below contains codes or descriptions that have changed in the DSM-5 from the DSM-IV TR. DSM-5 to ICD-9 crosswalk is available
More informationBehavioral Health Screening Coding Requirements
Behavioral Health Screening Coding Requirements The codes to be used to document the receipt of a Behavioral Health (Mental Health and Substance Abuse) Screening are as follows: Option 1: Evaluation and
More informationWashington State Regional Support Network (RSN)
Access to Care Standards 11/25/03 Eligibility Requirements for Authorization of Services for Medicaid Adults & Medicaid Older Adults Please note: The following standards reflect the most restrictive authorization
More informationEXHIBIT D, COVERED BEHAVIORAL HEALTH DIAGNOSES
EXHIBIT D, COVERED BEHAVIORAL HEALTH DIAGNOSES Part I- Mental Health Covered Diagnoses 295-298.9 295 Schizophrenic s (the following fifth-digit sub-classification is for use with category 295) 0 unspecified
More information11/26/08 ELIGIBLE POPULATION for DMHDD funded MH Services. Must have both I and II:
11/26/08 ELIGIBLE POPULATION for DMHDD funded MH Services AGE: Birth and older Must have both I and II: I. Diagnostic Criteria: "Mental illness" as used herein refers to "a mental or emotional disorder
More informationSurvey of Assaultive Behavior In IMDs Performance Improvement Project
Survey of Assaultive Behavior In IMDs Performance Improvement Project Instructions: Phone: Assaultive Behavior: Unwanted physical contact in an aggressive way, including hitting, kicking, punching, slapping,
More informationDiagnosis Codes Requiring PASRR Level II Updated 01.25.10.xls
V61.20 COUNSELING/CHILD PARENT COUNSELING FOR PARENT CHILD PROBLEM, UNSPECIFIED Mental Retardation V62.89 PSYCHOLOGICAL STRESS NECOTHER PSYCHOLOGICAL OR PHYSICAL STRESS, NOT ELSEWHERE Mental Retardation
More informationDementia in other diseases classified elsewhere with behavioral disturbance
MDC19 Mental Diseases & Disorders Assignment of Diagnosis Codes F0150 F0151 F0280 F0281 F0390 F0391 F04 F05 F060 F061 F062 F0630 F0631 F0632 F0633 F0634 F064 F068 F070 F079 F09 F200 F201 F202 F203 F205
More informationICD-9 Crosswalk (updated October 2007)
ICD-9 Crosswalk (updated October 2007) PS Descriptor 290.00 290.0 No X Senile dementia, uncomplicated 290.10 290.10 No X Presenile dementia, uncomplicated 290.11 290.11 No X Presenile dementia with delirium
More informationTABLE 6E--REVISED DIAGNOSIS CODE TITLES Page 1 of 9 October 1, 2004
TABLE 6E--REVISED DIAGNOSIS CODE TITLES Page 1 of 9 041.82 Bacteroides fragilis 070.41 Acute hepatitis C with hepatic coma 070.51 Acute hepatitis C without mention of hepatic coma 250.00 Diabetes mellitus
More informationColumn1 Mental Health Diagnosis Exclusion Codes (with attached SNOMED)
Column1 Mental Health Diagnosis Exclusion Codes (with attached SNOMED) ICD-9: Code Description 290.10 Presenile dementia, uncomplicated 290.11 Presenile dementia with delirium 290.12 Presenile dementia
More informationInformation for Lesson 10
Information for Lesson 10 Information regarding completion of the PASRR screen also known as (ODJFS 3622) or RR/ID To wrap up the course, we will discuss information related to the PASRR screen 3622. We
More informationBehavioral Health ICD-9
Behavioral Health ICD-9 Commonly used billable codes: ICD-9 Code ICD-9 Descriptor 293.83 Mood disorder in conditions classified elsewhere 293.84 Anxiety disorder in conditions classified elsewhere 293.89
More informationICD- 9 Source Description ICD- 10 Source Description
291.0 Alcohol withdrawal delirium F10.121 Alcohol abuse with intoxication delirium 291.0 Alcohol withdrawal delirium F10.221 Alcohol dependence with intoxication delirium 291.0 Alcohol withdrawal delirium
More informationDIAGNOSTIC RELATED GROUP (DRG) DESCRIPTIONS
Attachment B DIAGNOSTIC RELATED GROUP (DRG) DESCRIPTIONS 424 O.R. Procedure with of Mental Illness Any Operating Room Procedure 425 Acute Adjustment Reaction & Psychosocial Dysfunction 293.0 Acute delirium
More informationTransitioning to ICD-10 Behavioral Health
Transitioning to ICD-10 Behavioral Health Jeri Leong, R.N., CPC, CPC-H, CPMA Healthcare Coding Consultants of Hawaii LLC 1 Course Objectives Review of new requirements to ICD-10-CM Identify the areas of
More informationDSM-5 Table of Contents
DSM-5 Table of Contents DSM-5 Classification Preface Section I: DSM-5 Basics Introduction Use of the Manual Cautionary Statement for Forensic Use of DSM-5 Section II: Diagnostic Criteria and Codes Neurodevelopmental
More informationConsumer Eligibility, Enrollment and Benefit Status
Consumer Eligibility, Enrollment and Benefit Status 1. Eligibility Groups Individuals eligible for DHS/DMH funding of their mental health services may fall into one of the following categories: 1. Eligibility
More informationATTACHMENT A. ICD-9-CM MENTAL DISORDERS DIAGNOSIS CODES AND DESCRIPTIONS Subject to Certification of Admission/Concurrent/Continued Stay Review
ATTACHMENT A ICD-9-CM MENTAL DISORDERS DIAGNOSIS CODES AND DESCRIPTIONS Subject to Certification of Admission/Concurrent/Continued Stay Review This list contains principal diagnosis codes for psychiatric
More informationCrosswalk to DSM-IV-TR
Crosswalk to DSM-IV-TR Note: This Crosswalk includes only those codes most frequently found on existing CDERs. It does not include all of the codes listed in the DSM-IV-TR nor does it include all codes
More informationICD-9 Mental Health Billable Diagnosis Codes in Alphabetical Order by Description
ICD-9 Mental Health Billable Diagnosis Codes in Alphabetical Order by 313.83 ACADEMIC UNDERACHIEVMENT 309.23 ACADEMIC/WORK INHIBITION 298.3 ACUTE PARANOID REACTION 308.3 ACUTE STRESS REACT NEC 308.9 ACUTE
More information309.28 F43.22 Adjustment disorder with mixed anxiety and depressed mood Adjustment disorder with disturbance of conduct
Description ICD-9-CM Code ICD-10-CM Code Adjustment reaction with adjustment disorder with depressed mood 309.0 F43.21 Adjustment disorder with depressed mood Adjustment disorder with anxiety 309.24 F43.22
More informationDSM-5 Do Not Use ICD -10 Codes
DSM-5 Do Not Use ICD -10 Codes There are ICD-10 codes that DSM 5 is not compatible with. This spreadsheet details the ICD-10 codes that are NOT compatible with DSM 5. ICD10_DX_CD ICD10_DX_DESC F03.90 Unspecified
More informationBehavioral Health Diagnoses Not Subject to Visit Limits for Most HMSA Plans
Behavioral Health Diagnoses Not Subject to Visit Limits for Most HMSA Plans ICD-9 295.10 Schizophrenia, disorganized type 295.11 N/A Disorganized type schizophrenia, state Disorganized type schizophrenia,
More informationCRITERIA CHECKLIST. Serious Mental Illness (SMI)
Serious Mental Illness (SMI) SMI determination is based on the age of the individual, functional impairment, duration of the disorder and the diagnoses. Adults must meet all of the following five criteria:
More informationApprovable Antipsychotic ICD-9 Diagnoses
Page 6 Atypical Antipsychotics Approvable Antipsychotic ICD-9 Diagnoses Approvable ICD-9 Approvable Diagnosis Description Schizophrenic disorders 295.00 Simple Type Schizophrenia, Unspecified State 295.01
More informationDSM-IV to ICD-9 Codes Matrix
290.0 dementia of the Alzheirmer's type with late onset, uncomplicated 2900 Senile dementia, uncomplicated 290.1 Dementia of the Alzheimer's Type, early onset, uncomplicated 29010 Presenile dementia, uncomplicated
More informationAttachment 5 Arizona s Crosswalk for DC: 0-3R, DSM-IV-TR and ICD-10-CM 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
More informationReorganizing the diagnostic groupings in DSM-V and ICD-11: a cost/benefit analysis
Psychological Medicine (2009), 39, 2091 2097. f Cambridge University Press 2009 doi:10.1017/s0033291709991152 Reorganizing the diagnostic groupings in DSM-V and ICD-11: a cost/benefit analysis A commentary
More informationCritiques of Clinical Psychology. How Scientific is Clinical Psychology? Critiques
Critiques of Clinical Psychology How Scientific is Clinical Psychology? Jim Clark Books and other works Dawes: House of Cards Lillienfield et al: Science and Pseudoscience in Clinical Psychology Wright
More informationOverview of DSM-5. With a Focus on Adult Disorders. Gordon Clark, MD
Overview of DSM-5 With a Focus on Adult Disorders Gordon Clark, MD Sources include: 1. DSM-5: An Update D Kupfer & D Regier, ACP Annual Meeting, 2/21-22/13, Kauai 2. Master Course, DSM-5: What You Need
More informationICD-9-CM MENTAL DISORDERS DIAGNOSIS CODES AND DESCRIPTIONS
ATTACHMENT A ICD-9-CM MENTAL DISORDERS DIAGNOSIS CODES AND DESCRIPTIONS Subject to Certification of Admission/Concurrent/Continued Stay Review Based on the Admitting Diagnosis Code This list contains principal
More informationDSM-5: What Counselors Need to Know. Gary G. Gintner, Ph.D., LPC Louisiana State University Baton Rouge, LA gintner@lsu.edu
DSM-5: What Counselors Need to Know Gary G. Gintner, Ph.D., LPC Louisiana State University Baton Rouge, LA gintner@lsu.edu Disclosures Dr. Gintner has never received any funding or consulting fees from
More informationDSM-5 Brief Overview
COURSE TITLE: COURSE CODE: SME: WRITER: DSM-5 Brief Overview REL-DSM5-BO-0 Naju Madra, M.A. Naju Madra, M.A. Course Outline Section 1: Introduction A. Course Contributor B. About This Course C. Learning
More informationMENTAL DISORDERS ORGANIC PSYCHOTIC CONDITIONS (290 294.9)
MENTAL DISORDERS ORGANIC PSYCHOTIC CONDITIONS (290 294.9) 290 SENILE AND PRESENILE ORGANIC PSYCHOTIC CONDITIONS 290.0 SENILE DEMENTIA, SIMPLE TYPE 290.1 PRESENILE DEMENTIA 290.2 SENILE DEMENTIA, DEPRESSED
More informationAdvanced Abnormal Psychology (PSY 46000-01) CRN 12239 Fall Semester 2015 Dr. David Young, Professor of Psychology. Course Syllabus
Advanced Abnormal Psychology (PSY 46000-01) CRN 12239 Fall Semester 2015 Dr. David Young, Professor of Psychology Course Syllabus (Presentation Rubric) Monday, Wednesday, Friday, 10-10:50 a.m. Office:
More informationAll DSM 5 Diagnosis with ICD9 and ICD 10 Codes
All DSM 5 Diagnosis with ICD9 and ICD 10 Codes ICD-9-CM ICD-10-CM Disorder, condition, or problem V62.3 Z55.9 Academic or educational problem V62.4 Z60.3 Acculturation difficulty 308.3 F43.0 Acute stress
More informationHighlights of Changes from DSM-IV-TR to DSM-5
Highlights of Changes from DSM-IV-TR to DSM-5 Changes made to the DSM-5 diagnostic criteria and texts are outlined in this chapter in the same order in which they appear in the DSM-5 classification. This
More informationHighlights of Changes from DSM-IV-TR to DSM-5
Highlights of Changes from DSM-IV-TR to DSM-5 Changes made to the DSM-5 diagnostic criteria and texts are outlined in this chapter in the same order in which they appear in the DSM-5 classification. This
More informationMinnesota DC:0-3R Crosswalk to ICD Codes
Minnesota DC:0-3R Crosswalk to ICD DC 0-3R 0 Post-Traumatic Stress (this diagnosis must be considered first according to the DC:0-3R decision tree) 150 Deprivation/Maltreatment 200 of Affect 2 Prolonged
More informationDepression Remission at Six Months Specifications 2014 (Follow-up Visits for 07/01/2012 to 06/30/2013 Index Contact Dates)
Description Methodology Rationale Measurement Period A measure of the percentage of adults patients who have reached remission at six months (+/- 30 days) after being identified as having an initial PHQ-9
More informationBilling for other services for members in psychiatric residential treatment facilities
Billing for other services for members in psychiatric residential treatment facilities Summary: Psychiatric residential treatment facilities (PRTF) are an all-inclusive treatment program for children and
More informationPhenotype Processing Algorithm
Phenotype Processing Algorithm 1. Each individual has three associated variables which will be used for diagnostic classification. The variables are SZ, SA, and BS, which correspond to affection status
More informationPHENOTYPE PROCESSING METHODS.
PHENOTYPE PROCESSING METHODS. We first applied exclusionary criteria, recoding diagnosed individuals as phenotype unknown in the presence of: all dementias, amnestic and cognitive disorders; unknown/unspecified
More informationOverview of DSM-5 Changes. Christopher K. Varley, MD
Overview of DSM-5 Changes Christopher K. Varley, MD Disclosure to Audience No one involved in the planning or presentation of this activity has any relevant financial relationships with a commercial interest
More informationHighlights of Changes from DSM-IV-TR to DSM-5
Highlights of Changes from DSM-IV-TR to DSM-5 Changes made to the DSM-5 diagnostic criteria and texts are outlined in this chapter in the same order in which they appear in the DSM-5 classification. This
More informationTheoretical and Behavioral Foundations
Division: Theoretical and Behavioral Foundations Program Area: Educational Psychology Course #: EDP 7370 Course Title: Adult Psychopathology Section/ Reference #: 001/ 21302 Term/Year: Winter 2014 Course
More informationBehavioral Health Best Practice Documentation
Behavioral Health Best Practice Documentation Click on the desired Diagnoses link or press Enter to view all information. Diagnoses: DSM-5 and ICD-10 Codes Major Depressive Disorder Bipolar Disorder Eating
More informationICD-9-CM MENTAL DISORDERS DIAGNOSIS CODES AND DESCRIPTIONS
ATTACHMENT A ICD-9-CM MENTAL DISORDERS DIAGNOSIS CODES AND DESCRIPTIONS Subject to Certification of Admission/Concurrent/Continued Stay Review Based on the Admitting Diagnosis Code This list contains principal
More informationDSM-IV-TR CLASSIFICATION*
DSM-IV-TR CLASSIFICATION* NOS = Not Otherwise Specified An x appearing in a diagnostic code indicates that a specific code number is required. An ellipsis (...) is used in the names of certain disorders
More informationMental health issues in the elderly. January 28th 2008 Presented by Éric R. Thériault etheriau@lakeheadu.ca
Mental health issues in the elderly January 28th 2008 Presented by Éric R. Thériault etheriau@lakeheadu.ca Cognitive Disorders Outline Dementia (294.xx) Dementia of the Alzheimer's Type (early and late
More information[KQ 804] FEBRUARY 2007 Sub. Code: 9105
[KQ 804] FEBRUARY 2007 Sub. Code: 9105 (Revised Regulations) Theory : Two hours and forty minutes Q.P. Code: 419105 Maximum : 100 marks Theory : 80 marks M.C.Q. : Twenty minutes M.C.Q. : 20 marks 1. A
More informationABNORMAL PSYCHOLOGY PROVEN SCHOLARSHIP, ADAPTIVE LEARNING. McGRAW-HILL CONNECT ABNORMAL PSYCHOLOGY
ABNORMAL PSYCHOLOGY PROVEN SCHOLARSHIP, ADAPTIVE LEARNING Abnormal Psychology, Sixth Edition, was thoroughly updated to reflect the changes in the DSM-5, and chapters were reorganized in light of DSM-5
More informationDSM-5 ONLINE SCENARIO SIMULATOR UPDATED NATIONAL CLINICAL MENTAL HEALTH COUNSELING EXAMINATION ARTHUR-BRENDE STUDY SUPPLEMENT
ARTHUR-BRENDE STUDY SUPPLEMENT NATIONAL CLINICAL MENTAL HEALTH COUNSELING EXAMINATION ONLINE SCENARIO SIMULATOR DSM-5 TM Disorders: Diagnosis To Referral DSM-5 UPDATED 1 Gary L. Arthur, Ed.D., LPC, NCC,
More informationIndiana Association for Infant and Toddler Mental Health DC 0-3 R Crosswalk to DSM and ICD Systems
Indiana Association for Infant and Toddler Mental Health DC 0-3 R Crosswalk to DSM and ICD Systems Although the benefits of early identification and treatment of developmental and behavioral problems are
More informationDSM-5: Updates and Implications. Ryan Melton, Ph.D., LPC Portland State University Senior Research Faculty/EASA Clinical Director rymelton@pdx.
DSM-5: Updates and Implications Ryan Melton, Ph.D., LPC Portland State University Senior Research Faculty/EASA Clinical Director rymelton@pdx.edu Disclosures Dr. Melton has never received any funding or
More informationCHAPTER 5 MENTAL, BEHAVIOR AND NEURODEVELOPMENT DISORDERS (F01-F99) March 2014. 2014 MVP Health Care, Inc.
CHAPTER 5 MENTAL, BEHAVIOR AND NEURODEVELOPMENT DISORDERS (F01-F99) March 2014 2014 MVP Health Care, Inc. CHAPTER 5 CHAPTER SPECIFIC CATEGORY CODE BLOCKS F01-F09 Mental disorders due to known physiological
More informationAbnormal Psychology PSY-350-TE
Abnormal Psychology PSY-350-TE This TECEP tests the material usually taught in a one-semester course in abnormal psychology. It focuses on the causes of abnormality, the different forms of abnormal behavior,
More informationRESIDENTIAL TREATMENT FOR MENTAL HEALTH AND SUBSTANCE ABUSE DISORDERS
CLINICAL POLICY RESIDENTIAL TREATMENT FOR MENTAL HEALTH AND SUBSTANCE ABUSE DISORDERS Policy Number: BEHAVIORAL 020.9 T2 Effective Date: March 1, 2013 Table of Contents CONDITIONS OF COVERAGE... COVERAGE
More informationANXIETY CODING FACT SHEET FOR PRIMARY CARE CLINICIANS
ANXIETY CODING FACT SHEET FOR PRIMARY CARE CLINICIANS Current Procedural Terminology (CPT ) (Procedure) Codes Initial assessment usually involves a lot of time determining the differential diagnosis, a
More informationDSM-5. Coding Update. American Psychiatric Association. Supplement to Diagnostic and Statistical Manual of Mental disorders, Fifth Edition
DSM-5 Coding Update Supplement to Diagnostic and Statistical Manual of Mental disorders, Fifth Edition American Psychiatric Association March 2014 DSM-5 Coding Update Supplement to Diagnostic and Statistical
More informationCriteria to Identify Abnormal Behavior
Criteria to Identify Abnormal Behavior Unusualness Social deviance Emotional distress Maladaptive behavior Dangerousness Faulty perceptions or interpretations of reality Hallucinations Delusions Copyright
More informationDSM-5 OVERVIEW FOR CLINICIANS
DSM-5 OVERVIEW FOR CLINICIANS Developed and presented by: Roland Williams, MA, LAADC, ICADC, NCACII, CADCII, ACRPS, SAP President, Free Life Enterprises Roland Williams Consulting Agenda To highlight the
More informationCoding and Payment Guide for Behavioral Health Services
Coding and Payment Guide for Behavioral Health Services An essential coding, billing and reimbursement resource for psychiatrists, psychologists and clinical social workers 2015 Contents Introduction...1
More informationIllinois Insurance Facts Illinois Department of Insurance Mental Health and Substance Use Disorder Coverage
Illinois Insurance Facts Illinois Department of Insurance Mental Health and Substance Use Disorder Coverage Revised October 2012 Note: This information was developed to provide consumers with general information
More informationDSM-5 SUMMARY PAGES DEPRESSIVE DISORDERS:
DSM-5 SUMMARY PAGES 1 Pillar I: Mood Disorders Pillar II: Psychotic Disorders Pillar III: Anxiety & OCD Disorders Pillar IV: Substance Abuse & Other Addictions Neurodevelopmental Disorders: ADHD, Autism
More informationOptum By United Behavioral Health. 2015 Florida Medicaid Managed Medical Assistance (MMA) Level of Care Guidelines
Optum By United Behavioral Health 2015 Florida Medicaid Managed Medical Assistance (MMA) Level of Care Guidelines Therapeutic group care services are community-based, psychiatric residential treatment
More informationDEPRESSION CODING FACT SHEET FOR PRIMARY CARE CLINICIANS
DEPRESSION CODING FACT SHEET FOR PRIMARY CARE CLINICIANS Current Procedural Terminology (CPT ) (Procedure) Codes Initial assessment usually involves a lot of time determining the differential diagnosis,
More informationDEPRESSION CODING FACT SHEET FOR PRIMARY CARE CLINICIANS
DEPRESSION CODING FACT SHEET FOR PRIMARY CARE CLINICIANS Current Procedural Terminology (CPT ) (Procedure) Codes Initial assessment usually involves a lot of time determining the differential diagnosis,
More informationMental Health Nursing - Theory of Psychiatric Disorders
The Al-albayt University Faculty of Nursing B.Sc of Nursing Program Course Title: Mental Health Nursing- Theory Course Number: 1001442 Credit Hours: 3 Credit Hours Course Prerequisites: 1001331 or 1001335
More informationPlanning Services for Persons with Developmental Disabilities and Mental Health Diagnoses
Planning Services for Persons with Developmental Disabilities and Mental Health Diagnoses Persons with Intellectual Disabilities (ID) have mental disorders three to four times more frequently than do persons
More informationHow to Read the DSM-IV A Tutorial for Beginners
How to Read the DSM-IV A Tutorial for Beginners By Dr. Robert Tippie, Ph.D. MARET Systems International Previously we explained the validity of pastors using the DSM-IV. In this article we will discuss
More informationREPORT TO THE LEGISLATURE Pursuant to P.A. 114 of 2009 Section 612(4) Parole/Probation Violators 4 th Quarter Report (May 2010 July 2010 Data)
REPORT TO THE LEGISLATURE Pursuant to P.A. 114 of 2009 Section 612(4) Parole/Probation Violators 4 th Quarter Report (May 2010 July 2010 Data) Section 612(4) of 2009 P.A.114 requires that the Department
More informationMEDICAL POLICY POLICY TITLE POLICY NUMBER NEUROPSYCHOLOGICAL TESTING (FOR MEDICAL PURPOSES) MP-4.027
Original Issue Date (Created): July 1, 2005 Most Recent Review Date (Revised): November 26, 2013 Effective Date: February 1, 2014 I. POLICY Neuropsychological testing may be considered medically necessary
More informationDIAGNOSIS CODE SET CROSSWALK FOR DC:0-3R TO ICD-9-CM
DIAGNOSIS SET CROSSWALK FOR TO -CM DESCRIPTION 15 I 100 Posttraumatic Stress Disorder 309.81 17 I 150 19 I 200 19 I 210 20 I 220 Deprivation/Maltreatment Disorder 313.89 Disorders of Affect (see 210-240)
More informationBEHAVIORAL HEALTH SERVICES
BEHAVIORAL HEALTH SERVICES ADMINISTRATIVE POLICY Policy Number: BEHAVIORAL 021.11 T0 Effective Date: May 1, 2015 Table of Contents BENEFIT CONSIDERATIONS APPLICABLE LINES OF BUSINESS/PRODUCTS. PURPOSE..
More informationChapter 14. Psychological Disorders
Chapter 14 Psychological Disorders We ve Come a Long Way Trepanning Ancient priests or medicine men cut holes into the skills of living persons, to release the demons. What is Abnormality Psychopathology
More informationGAIN and DSM. Presentation Objectives. Using the GAIN Diagnostically
GAIN and DSM GAIN National Clinical Training Team 2011 Version 2 Materials Presentation Objectives Understand which DSM diagnoses are generated by GAIN ABS for the GAIN reports and which ones must be added
More informationENTITLEMENT ELIGIBILITY GUIDELINE
ENTITLEMENT ELIGIBILITY GUIDELINE BIPOLAR DISORDERS MPC 00608 ICD-9 296.0, 296.1, 296.4, 296.5, 296.6, 296.7, 296.8, 301.13 ICD-10 F30, F31, F34.0 DEFINITION BIPOLAR DISORDERS Bipolar Disorders include:
More informationFeeling Moody? Major Depressive. Disorder. Is it just a bad mood or is it a disorder? Mood Disorders. www.seclairer.com S Eclairer 724-468-3999
Feeling Moody? Is it just a bad mood or is it a disorder? Major Depressive Disorder Prevalence: 7%; 18-29 years old; Female>Male DDx: Manic episodes with irritable mood or mixed episodes, mood disorder
More informationDr. Renee Boomgaarden, PhD February 9, 2014
Dr. Renee Boomgaarden, PhD February 9, 2014 Removal of Multiaxial System Removal of NOS New Diagnostic Codes Restructuring of Diagnostic Categories Dimensional vs Categorical Classification ICD Developed
More informationhepatolenticular degeneration (E83.0) human immunodeficiency virus [HIV] disease (B20) hypercalcemia (E83.52) hypothyroidism, acquired (E00-E03.
ICD-10-CM Codes for Mental, Behavioral and Neurodevelopmental Disorders Chapter 5 Mental, Behavioral and Neurodevelopmental disorders (F01-F99) Includes: disorders of psychological development Excludes2:
More informationBehavioral Health ICD-9-CM Codes Considered for Payment under HIPAA Effective 7/1/2011
290.0 SENILE DEMENTIA UNCOMP All MH Codes 290.10 PRESENILE DEMENTIA UNCMP All MH Codes 290.11 PRESENILE DELIRIUM All MH Codes 290.12 PRESENILE DELUSION All MH Codes 290.13 PRESENILE DEPRESSION All MH Codes
More informationADHD Coding Fact Sheet for Primary Care Pediatricians
CARING FOR CHILDREN WITH ADHD: A RESOURCE TOOLKIT FOR CLINICIANS, 2ND EDITION ADHD Coding Fact Sheet for Primary Care Pediatricians CPT (Procedure) Codes Initial assessment usually involves a lot of time
More informationState Mental Health Parity Laws
Type of Law Comprehensive parity Equal coverage of a broad range of mental health conditions, including substance abuse. Does not exempt significant policy groups. Broad-based parity Equal coverage of
More information2014 ICD-9-CM Mental, Behavioral and Neurodevelopmental Disorders
THE ICD-9 DIAGNOSTIC CODES THAT ARE LISTED HERE ARE 2014-ICD-9-CM CODES. THEY ARE THE CURRENT DIAGNOSTIC CODES UTILIZED IN INSURANCE BILLING. THE ICD-10 IS EXPECTED TO BE RELEASED IN OCTOBER 2015. NOTE:
More informationDiagnostic and Statistical Manual Of Mental Disorders. Changing from DSM-IV to DSM-5
Diagnostic and Statistical Manual Of Mental Disorders Changing from DSM-IV to DSM-5 Steve Franklin Shelly Justison Kathleen McMullan (Thanks to Dr. Donald W. Black Author of DSM-5 Guidebook ) MSCSW September
More informationChildren s Community Health Plan INTENSIVE IN-HOME MENTAL HEALTH / SUBSTANCE ABUSE SERVICES ASSESSMENT AND RECOVERY / TREATMENT PLAN ATTACHMENT
Children s Community Health Plan INTENSIVE IN-HOME MENTAL HEALTH / SUBSTANCE ABUSE SERVICES ASSESSMENT AND RECOVERY / TREATMENT PLAN ATTACHMENT Please fax with CCHP prior authorization form to 608-252-0853
More informationSmoky Mountain Center LME-MCO Care Coordination
Smoky Mountain Center LME-MCO Care Coordination Care Coordination activities include the identification, coordination and monitoring of, linkage to behavioral health treatment services and/or habilitative
More information