Frequently Asked Questions

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FAQ

In current practice by the mental health field, many clinicians use the DSM-IV in diagnosing mental disorders. As of May 19, 2013, the Fifth Edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was released by the American Psychiatric Association (APA). Can these clinicians continue current practice and use the DSM-IV and DSM-5 diagnostic criteria?

Yes. It is expected that clinicians may continue to base their diagnostic decisions on the DSM-IV/DSM-5 criteria. In addition, it is still perfectly permissible for providers and others to use the DSM-IV and DSM-5 descriptors and disgnostic criteria for other purposes, including medical records, quality assessment, medical review, consultation, and patient communications.

Once the clinician has arrived at the clinical diagnosis and documented it in the medical record, the appropriate diagnosis code(s) should be assigned. Code assignment can be accomplished using a variety of resources. These resources may include ICD-10-CM code books, specialty specific code books, electronic versions of the ICD-10-CM posted on CMS’ website at http://www.cms.gov/Medicare/Coding/ICD10/index.html and the CDC website at http://www.cdc.gov/nchs/icd.htm, and encoders.

ICD-9-CM codes should be used for reporting the diagnosis codes associated with services furnished up to, and including, September 30, 2015.  As of October 1, 2015, the ICD-10-CM code set will become the HIPAA adopted standard and will be required for reporting diagnosis codes for dates of service on and after October 1, 2015.

DSM-5 contains the standard criteria and definitions of mental disorders now approved by the American Psychiatric Association (APA), and it also contain both ICD-9-CM and ICD-10-CM codes (in parentheses) selected by APA. Since DSM-IV only contains ICD-9-CM codes, it will cease to be recognized for criteria or coding for services with dates of service of October 1, 2015 or later. Updates for DSM-5 criteria and their associated ICD-10-CM codes (identified by APA) will be found at http://www.dsm5.org.


(FAQ1817)

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