Important Changes in DSM-5 to Become Effective October 1

Each year on October 1, the International Classification of Diseases, Tenth Edition, Clinical Modification (ICD-10), is updated to reflect diagnostic  changes in medicine. Since 2010, no major updates have been permitted so that physician practices, facilities, and payers in the United States could update their systems during the transition from ICD-9 to ICD-10, which went into effect on October 1, 2015.

APA has advocated that changes be made to ICD-10 to reflect the updated diagnoses in DSM-5. These include changes to align the terminology used in DSM-5 with that used in the mental health chapter of ICD-10. In response, the Fiscal Year 2017 version of ICD-10, which takes effect October 1, will include most of DSM-5’s terminology.

In some cases, new codes have been added to ICD-10 to accommodate the new diagnoses that were added to DSM-5. The new codes will allow more accurate diagnostic recording, improved communication among clinicians, and better means for collecting prevalence data.

As of October 1, the codes for the DSM-5 disorders in the chart below will no longer be valid. The new codes listed in the chart must be used in their place.

A printable version of the list is available at http://APAPsy.ch/ICD-DSM and includes the diagnoses in both alphabetical order and the order in which they appear in the DSM-5 classification.

Are Your 1500 Forms Being Rejected? Here’s Help!

APA has received reports that Medicare providers who file 1500 Health Insurance Claim Forms are having a large number of their claims returned due to a change in the reporting requirements that went into effect on October 1.

Medicare contractors are returning claims for correction or resubmission to mental health professionals who fail to indicate in line item 21 of the 1500 claim form whether ICD-9 or ICD-10 codes are used.

For services that were provided prior to October 1, ICD-9 codes should be used even if the claim is filed after that date; for services on or after October 1, 2015, ICD-10 codes should be used. ICD-9 codes are indicated by using a 9 in item #21; ICD-10 codes are noted with a 0.

Also, though there is some inconsistency among what payers are accepting, the general feedback that APA is receiving is that codes submitted in Item 21 should not contain a decimal point (for example, the code F43.10 should be submitted as F4310).

DSM-5 lists both the ICD-9 and the ICD-10 codes for each diagnosis. The ICD-9 codes are in black ink and the ICD-10 codes are to the right of them in gray ink.

For information about how to implement ICD-10 codes using DSM-5, see Using DSM-5 in the Transition to ICD-10.

We encourage you to provide us with feedback regarding any problems you have with the claims you file by sending an email to dsm5@psych.org. The more feedback we receive from you, our practitioners, the better we can communicate tips like the above to help ensure that your claims are accepted.