Health Insurance Portability Act

The ICD-10-CM Compliance date is

October 1st, 2015

Payers will only accept claims with ICD-10 codes with dates of service (or dates of discharge) on or after October 1st, 2015.  Payers will deny claims with invalid codes based on the date of service or discharge. ICD-9 codes will be accepted on claims with dates of service (or dates of discharge) through September 30th, 2015.

The transition to ICD-10 is required for everyone covered by the Health Insurance Portability Act (HIPAA). Please note, the change to ICD-10 does not affect CPT or HCPCS Level II coding for outpatient procedures and physician services.

Major Differences Between

ICD-9-CM & ICD-10-CM

Comparison of ICD-9-CM

& ICD-10-CM

 

ICD-9-CM Code

A – Category of code

B – Etiology, anatomical site, and the manifestation

 

XXX.XX

A B

 

ICD-10-CM Code

A – Category of code

B – Etiology, anatomical site, and/or severity

C – Extension

7th character for obstetrics, injuries, and external causes of injury

 

XXX.XXXX

A B C

Examples of ICD-9-CM vs

& ICD-10-CM

Description ICD-9 code ICD-10 code
Chronic motor or vocal tic disorder 307.22 F95.1
Psychotic disorder with delusions 293.81 F06.2
Mood disorder due to known physiological condition unspecified 293.83 F06.30
Unspecified schizophrenia unspecified 295.90 F20.9
Schizoaffective disorder, unspecified 295.70 F25.9

Let’s Review some ICD-10-CM

Psychiatric Conditions

 

DSM-V

Psychiatrists generally state diagnoses in accordance with the nomenclature used in the Diagnostic and Statistical Manual of Mental Disorders.