HI 255 Medical Coding II Unit Two Seminar Regina L Kraus, MSA,RHIT, CPHQ Kaplan University, School of Health Sciences
Medical Coding II Week Two Activities Read Chapters 10 and 21 in Textbook; Attend Seminar or complete Seminar Option 2; Complete Exercise inn e-College
Understanding ICD-9-CM Coding Mary Jo Bowie MS, RHIA, RHIT Regina Schaffer AAS, RHIA, CPC
CHAPTER Mental Disorders 10
Terminology Diagnostic and Statistical Manual of Mental Disorders—Fourth Revision, DSM-IV Nomenclature may differ American Psychiatric Association
Coding Mental Disorders Three sections of codes: Psychoses—category codes 290–299 Neurotic disorders, personality disorders and other nonpsychotic mental disorders—category codes 300–316 Mental disorders—category codes 317–319
Psychoses 290–299 Conditions interfering with ability to carry on activities of daily living Psychotic behaviors Dementia Alcoholic psychoses Organic psychotic conditions Schizophrenic disorders
Dementia 290 Progressive disease that decreases mental abilities Fourth digit identifies type of dementia Senile dementia—290.0 Pre-senile dementia—290.1X Senile dementia with delusional/depressive features—290.2X Vascular dementia—290.4X
Fifth-Digit Subcategories Fifth digit identifies dementia with related conditions such as: Delirium Delusions Depressive feature Reference of provider documentation is key
Instructional Notation “Use additional code to identify cerebral atherosclerosis” Found only if Tabular Listing was referenced
Alcohol/Drug-Induced Mental Disorders Category 291—Alcohol Category 292—Drug History of abuse does NOT support use of code from these categories Instructional notations must be followed
Other Psychoses 295–299 Schizophrenic disorders Bipolar disorders Delusional disorders Neurotic disorders Personality disorders
Virtual Tour Link and Instructions HI 255 Medical Coding II Virtual Tour Link and Instructions Please review the following video by following the link in the bottom left hand box : When complete, please type ‘done’ in the chat box and return to seminar. Think about your own opinions about mental illness. Has it changed? http://videos.howstuffworks.com/tlc/28672-understanding-brain-schizophrenia-video.htm
Fifth-Digit Code Assignment Instructional notations may influence fifth-digit code assignment Assignment of fifth digit depends on provider documentation Specific diagnostic statements
Category Codes 300–316 Neurotic, personality, and other non-psychotic disorders are coded to this category
Category Codes 300–316 Patient lives within socially acceptable limits but experiences: Anxiety Phobias Nonpsychotic mental disorders due to brain damage
Terms Related to Alcohol Abuse Alcohol abuse—drink to excess, not physically dependent Alcohol dependence—known as alcoholism Person is unable to stop drinking Negative effects on all aspects of their life
Terms Related to Drug Abuse Drug abuse—taking drugs to excess but not dependent on them Drug dependence—chronic use of drugs creating compulsion to take them
Fifth-Digit Assignment For category codes 303, 304, and 305: 0 Unspecified 1 Continuous 2 Episodic 3 In remission
Fifth-Digit Assignment Medical documentation needs to support the use of a fifth-digit assignment of 1, 2, or 3
Depressive Disorder 311 Not widely accepted by insurance companies for use by primary care providers Instructional notations should be followed
Mental Retardation 317–319 Cognitive abilities never fully developed Based on current level of functioning: Mild Moderate Severe Profound Unspecified