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Actually… there is no such thing as DSM-5 codes!

DSM-5 is a set of diagnosis classifications, criteria, and descriptions. The codes associated with the DSM-5 diagnosis are actually the ICD-9 codes and ICD-10 codes used for insurance billing.

Here’s an easy way to keep them straight:

The DSM-5 is exclusive to behavioral health and contains criteria for diagnosing behavioral health disorders. The extensive descriptive text provides a common language for clinicians to communicate about their patients.

ICD codes are used for all medical diagnosis needed for insurance reimbursement and for monitoring of morbidity and mortality statistics by national and international health agencies.

So if ICD codes are used for reimbursement, what do we need the DSM for? The DSM provides a consistent criterion to arrive at a diagnosis. It also accounts for the long time split between medical diagnosis and mental diagnosis. While ICD-10 takes big strides in minimizing this gap, some argue it does not go far enough. Sometimes the same ICD code is used for multiple DSM-5 diagnosis. For example, “Hoarding disorder” and “Obsessive-compulsive disorder” both share the F42 code in ICD-10 (they shared a code in ICD-9, too).

It is important for practices and organizations to transition to DSM-5 before the Oct.1, 2015 ICD-10 deadline. DSM-IV diagnoses only correlate to ICD-9 and will therefore be less accurate and unsuitable for billing come October.

How should your practice or organization prepare? Check out our blog: “How can you optimize for DSM-5? Here’s your implementation plan.”

Special thanks to American Psychiatric Association for the definitions.

Click the button below to see a demonstration of how Valant is helping Behavioral Health professionals ease the transition to ICD-10 and DSM-5: