Psychologists and other health professionals have a fast-approaching deadline to contend with in their already busy schedules. The U.S. Department of Health and Human Services (HHS) issued a final ruling that October 1, 2015 is the mandatory compliance date for all entities subject to the Health Insurance Portability and Accountability Act (HIPAA) requirements to transition to the ICD-10-CM.
On this date, the ICD-10 coding classification will become the new baseline for clinical data, clinical documentation, claims processing and public health reporting. At this time there is no indication that a delay or extension will be presented: Beginning October 1, 2015, claims filed using prior versions of the codes from the ICD-9-CM will be denied as unprocessable.
With nearly five times as many codes as the previous version, the ICD-10-CM proves beneficial for psychologists as more specificity will be routinely captured in diagnoses. This can lead to greater individualized care, advanced treatment planning, superior care coordination across fields and improved reliability in research settings.
However, with the increased diagnostic nuances come a significant administrative learning curve as well. The American Psychological Association Practice Organization (APAPO) has developed several resources to assist members in creating a smooth transition to the new coding system. Three basic steps are recommended to help with the transition.
The first component is understanding how the basic structure of the upcoming ICD-10-CM varies from the current structure of the ICD-9-CM. Psychologists will typically use Chapter 5 entitled Mental, Behavioral and Neurodevelopmental Disorders. However, disorders related to amnesia and care-provider dependencies, for example, are not found in this behavioral health chapter.
Familiarity should also be developed with Chapter 6 (Diseases of the Nervous System), Chapter 18 (Symptoms, Signs and Abnormal Clinical and Laboratory Findings, not otherwise classified) and Chapter 21 (Factors Influencing Health Status and Contact with Health Services). And those working in other areas of health will want to become familiar with any additional relevant chapters.
While the former version of the ICD had a mostly numeric structure, the ICD-10-CM utilizes an alphanumeric coding structure. For example, previously the code for Post-Traumatic Stress Disorder was simply 309.81. The new coding could be either F43.10, F43.11 or F43.12. Each component of the code refers to specific diagnostic information. The letter “F” in this new code refers to the chapter “Mental, Behavioral and Neurodevelopmental Disorders,” while the “43” refers to the section “Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders.” Finally, the numbers following the decimal point refer to specifiers such as “acute” or “chronic.” Further information on coding structure can be found at apapracticecentral.org.
The second recommended transitional step is to take advantage of the many resources provided for making a successful conversion. The ICD-10-CM Tabular List of Diseases and Injuries is made available for free online via the Centers for Disease Control and Prevention (CDC). This is an easily navigated document that includes all chapters, subsections and associated codes.
Alternatively, several ICD-9-CM to ICD-10-CM code conversion websites are available for free public access. One such site is ICD10Data.com. It is important to note that these websites are not sanctioned by the CDC and should not be the sole source for establishing the accuracy of conversion data.
The American Psychological Association and APAPO are committed to being a resource for information regarding this upcoming transition. An APA publication entitled “A Primer for ICD-10-CM Users: Psychological and Behavioral Conditions” was specifically created to assist mental health professionals by providing a thorough overview and detailed instructions on navigating the new system. This resource can be purchased via apa.org/pubs/books/4317336.aspx. APAPO members have free access to a web-based ICD-10-CM application. This portal includes the ability to search by keyword, navigate categories of diagnoses or even explore graphical interfaces. Further details can be found at apapracticecentral.org/update/2014/12-18/member-benefit.aspx.
This article is included in the July/August 2015 edition of The National Psychologist, a private, independent bi-monthly newspaper intended to keep psychologists informed about practice issues. Psychologists and other mental health professionals can earn one hour of continuing education credit for reading articles included in the newspaper and completing the CE quiz online @ www.pdresources.org.
Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists. Professional Development Resources maintains responsibility for this program and its content. Professional Development Resources is also approved by the Florida Board of Psychology and the Office of School Psychology and is CE Broker compliant (#50-1635).