American Psychiatric Association explains DSM-5, behavioral health codes and ICD-10

By Darrel A. Regier, MD
08:01 AM

In the blog titled: How to Get Your Behavioral Health Codes Right, which was posted February 17th, it was stated that "According to CMS, '…neither the DSM-IV nor the DSM-5 is a HIPAA Compliant code set. Therefore Behavioral Health specialists must use ICD-9 CM codes and after October 1, 2014 the appropriate ICD-10 CM diagnosis code.'” 

This statement has led to some confusion about DSM 5 diagnosis and ICD codes which is clarified here. 

The DSM-5 provides criteria for diagnosing mental disorders, and provides additional information to assist mental health practitioners in coming to an accurate diagnosis- it is akin to a medical textbook. ICD codes are just that – codes for a particular diagnosis that contain no diagnostic criteria or other information. For convenience of the user, DSM-5  also provides the HIPAA compliant ICD codes that are associated with each diagnosis found in DSM.  It is the ICD code for a particular diagnosis that is recorded on health insurance and other forms. When DSM-5 was created, the authors were aware that ICD-10-CM would be implemented as the standard medical coding system for use in the United States beginning October 1st, 2014.

Because DSM-5 was released in May, 2013, APA included both the valid and HIPAA compliant ICD-9-CM code and ICD-10-CM code associated with each disorder so that the diagnostic criteria and the HIPAA complaint ICD codes could readily be found in one place. 

Accordingly, the only codes in DSM-5 are ICD-9 and ICD-10 codes and both are HIPAA compliant.

For example, when one views a diagnostic title in DSM-5, it contains two ICD codes for the diagnosis – the first is the ICD-9 code which is effective until October 1, 2014 and the second, which appears in parenthesis is ICD-10 which is required as of October 1, 2014 – and appears in this snapshot of a DSM-5 page as follows: 

 

 

 

 

 

 

 

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