ICD-10-CM Provider Training Mini-Series. Session 6: Major Depressive Disorder (MDD)

Transcription

1 ICD-10-CM Provider Training Mini-Series Session 6: Major Depressive Disorder (MDD) Y0114_15_25800_I_005_09/15/2015

2 Disclaimer Welcome to the ICD-10-CM ( ICD-10 ) Provider Training Mini-Series! The ICD-10 Provider Training Mini-Series is a series of six presentations consisting of ICD-10 coding and documentation tips. As you review the materials, you will see that the first session is an introduction to ICD-10 coding and the remaining five sessions focus on ICD-10 coding guidelines related to specific conditions. These trainings are based on coding guidance from the Official ICD-10-CM Coding Guidelines, American Hospital Association s (AHA) Coding Clinic, and/or Centers for Medicare and Medicaid Services (CMS) guidance and guidelines. Documentation recommendations are based on the official requirements for correct code assignment per the aforementioned guidelines. Coding guidelines and references are updated on an annual basis potentially impacting the accuracy of the content contained within this presentation. Reference the Official Coding Guidelines for up-to-date information. The contents included in this presentation are for informational purposes only. Coding guidance provided does not, nor intends to, replace the Official Coding Guidelines or an individual s professional coding expertise. Providers should ensure that documentation supports all codes submitted for conditions and services. Individual health plan payers may have specific requirements regarding coding in provider contracts. Providers should consult contract language and contact health plan representatives to fully understand any contractual coding requirements. Blue Cross and Blue Shield of Georgia, Inc.does not guarantee that the information supplied is without defect. Every attempt has been made to ensure its accuracy, completeness, and relevance. 2

3 Topics Covered In This Series: MDD Definition ICD-9 Versus ICD-10 ICD-10 MDD Code Breakdown Documentation for MDD Linking Verbiage, Depression and Anxiety Dysthymia References & Resources 3

4 Major Depressive Disorder (MDD) Per Encoder Pro: Mood disorder that produces depression; may exhibit as sadness, low selfesteem, or guilt feelings; other manifestations may be withdrawal from friends and family; interrupted sleep. 4

5 ICD-9 Versus ICD-10 In ICD-9, depression unspecified leads to code 311 (depressive disorder, not otherwise specified) listed under Other Nonpsychotic Mental Disorders. ICD-10, depression unspecified leads to code F32.9 (major depressive disorder, single episode, unspecified) listed under Mood [Affective] Disorders Depression NOS ICD Major depressive disorder, single episode, unspecified ICD-10 F32.9- Major depressive disorder, single episode, unspecified (Depression NOS) 5

6 ICD-10 MDD Code Breakdown: Severity Major Depressive Disorder Categories F32-F33 F33.40-F33.42 Remission status 6

7 Documentation for Depression In order to code to the highest degree of specificity, depression should include documentation of: Type Episode Severity Remission Status Major Chronic Anxiety Atypical Manic-depressive Masked Neurotic Situational Other types of depression Single Recurrent Other depressive episode Mild Moderate Severe with or without psychotic features Partial remission Full remission 7

8 Linking Verbiage, Depression and Anxiety Depression and anxiety are coded separately unless a documented linkage between the two conditions has been established. Examples of linking verbiage: Depression anxiety Anxiety depression Depression with anxiety Depression associated with anxiety Documentation for depression with anxiety should also include severity such as mild (F41.8, anxiety depression) or persistent (F34.1, dysthymic disorder) in order to code to the highest level of specificity. 8

9 Dysthymia Dysthymia is a mild but long-term (chronic) form of depression (Mayo Clinic). In ICD-10: Dysthymia leads to code F34.1 (dysthymic disorder) There isn t a code selection for chronic depression. The default is depression NOS (F32.9, Major depressive disorder, single episode, unspecified) To assign a more precise ICD-10 code, ensure the diagnosis is documented to the highest degree of specificity in the medical record. 9

10 To better prepare yourself, check out the complete ICD-10 Provider Training Mini-Series: Session 1- Introduction to ICD-10-CM Session 2- Chronic Obstructive Pulmonary Disease Session 3- Diabetes Session 4- Rheumatoid Arthritis Session 5- Congestive Heart Failure Session 6- Major Depressive Disorder 10

11 References & Resources: Contexo, International Classification of Diseases 10 th Revision Clinical Modification, Draft Optum EncoderPro.com American Hospital Association (AHA) Coding Clinic, Quarter 4, 2013, Chronic Depression 11