1. HI 255 Medical Coding II Unit Two Seminar
Regina L Kraus, MSA,RHIT, CPHQ
Kaplan University, School of Health Sciences

2. 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

3. Understanding ICD-9-CM Coding
Mary Jo Bowie MS, RHIA, RHIT
Regina Schaffer AAS, RHIA, CPC

4. CHAPTER
Mental Disorders 10

5. Terminology
Diagnostic and Statistical Manual of Mental Disorders—Fourth Revision, DSM-IV
Nomenclature may differ
American Psychiatric Association

6. 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

7. Psychoses 290–299
Conditions interfering with ability to carry on activities of daily living
Psychotic behaviors
Dementia
Alcoholic psychoses
Organic psychotic conditions
Schizophrenic disorders

8. 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

9. Fifth-Digit Subcategories
Fifth digit identifies dementia with related conditions such as:
Delirium
Delusions
Depressive feature
Reference of provider documentation is key

10. Instructional Notation
“Use additional code to identify cerebral atherosclerosis”
Found only if Tabular Listing was referenced

11. 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

12. Other Psychoses 295–299 Schizophrenic disorders Bipolar disorders
Delusional disorders
Neurotic disorders
Personality disorders

13. 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?

14. Fifth-Digit Code Assignment
Instructional notations may influence fifth-digit code assignment
Assignment of fifth digit depends on provider documentation
Specific diagnostic statements

15. Category Codes 300–316
Neurotic, personality, and other non-psychotic disorders are coded to this category

16. Category Codes 300–316
Patient lives within socially acceptable limits but experiences:
Anxiety
Phobias
Nonpsychotic mental disorders due to brain damage

17. 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

18. 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

19. Fifth-Digit Assignment
For category codes 303, 304, and 305:
0 Unspecified
1 Continuous
2 Episodic
3 In remission

20. Fifth-Digit Assignment
Medical documentation needs to support the use of a fifth-digit assignment of 1, 2, or 3

21. Depressive Disorder 311
Not widely accepted by insurance companies for use by primary care providers
Instructional notations should be followed

22. Mental Retardation 317–319 Cognitive abilities never fully developed
Based on current level of functioning:
Mild
Moderate
Severe
Profound
Unspecified