2. Implementation of ICD 10 deadline
The U.S. health care system relies on a set of codes, referred to as ICD-9, to report diagnoses which was introduced in the late 1970s, the ICD-9 code set will soon be replaced by the more detailed ICD-10, with a deadline for the transition of October 1, 2015.

3. The transition from ICD-9 to ICD-10 is a major transition, as it reflects a five-fold increase in diagnosis codes, to roughly 69,000 codes.
If a medical practice or insurance payer doesn't switch to ICD-10 by the deadline, claims cannot be processed.

4. Mental Health providers have over 300 new diagnosis codes that range from F01-F99

5. One of the MYTHS of ICD10 is that the increased number of codes will make the new coding system impossible to use.
In FACT, just as an increase in the number of words in a dictionary doesn’t make it more difficult to use, the greater number of codes in ICD10 doesn’t make it more complex to use.
The greater number of codes in ICD10 make it easier for you to find the right code.

6. CHALLENGES FOR MENTAL HEALTH PROVIDERS USING ICD10

7. MULTIPLE DIAGNOSIS Precedence should be given to the diagnosis that best represents the Nature of the Presenting Problem and is most relevant to the purpose of the visit ** Best practice: record the diagnosis in the numerical order in which they appear in the ICD10 classification

8. TERMINOLOGY CHANGE The term “disorder” is used throughout the classification, in order to keep it separate from terms that often seem to be interchanged like “disease” and “illness”. The term “disorder” is used to allow the existence of a clinically recognizable set of symptoms and/ or behavior often associated with distress and disruption of personal function.

9. SUBSTANCE ABUSE, USE AND DEPENDENCY Although ICD9 doesn’t distinguish between use, abuse and dependency, ICD10 does. Many of the codes in this section also specify complications such as mood disorders, delusion, delirium, perceptual disturbances and much more. Providers can only submit one code per substance, so be clear the documentation associated with the psychoactive substance is clearly stated.

10. BEHAVIORHAL & MENTAL HEALTH DOCUMENTION TIP SHEET FOR ICD10
DOCUMENTATION
BEHAVIORHAL & MENTAL HEALTH DOCUMENTION TIP SHEET FOR ICD10

11. ADD and ADHD
Document type:
- Predominantly inattentive
- Predominantly hyperactive
- Combined type
Adjustment Disorder
- Depressed mood
- Anxiety
- Mixed anxiety and depressed mood
- Disturbance of conduct
- Mixed disturbance of emotions and conduct
Alcohol/ Drug Abuse and Dependence
Differentiate between alcohol/substance abuse versus dependence
-Do not document “use” as a substitute for abuse or dependence
Dependence, document if in remission which is based on your clinical judgment
Document any substance induced disorders or complications:
-Anxiety disorder
-Delirium
-Delusions
-Hallucinations
-Psychotic disorder

12. - With behavioral disturbance - Without behavioral disturbance
Bipolar Disorder
Document current episode:
- Hypomanic
- Manic
- Depressed
- Mixed
Specify severity for manic and depressed episodes:
- Mild
- Moderate
- Severe w/o psychotic symptoms
- Severe with psychotic symptoms
Indicate status:
- Full remission
- Partial remission
Conduct Disorder
Document:
- Confined to family context
- Childhood-onset type
- Adolescent-onset type
- Oppositional defiant
Dementia
- With behavioral disturbance
- Without behavioral disturbance
Document underlying condition (e.g. Alzheimer's, Parkinson's, Vit B deficiency
Document vascular dementia as a result of infarction

13. Depression
Document type:
- Major depression (see Major Depressive Disorder below)
- Adjustment disorder with or without depression and/or anxiety, e.g., grief reaction
- Anxiety depression
- Depressive neurosis
Drug Underdosing
Document:
- Intentional
versus
- Unintentional
Document reason for underdosing:
- Financial hardship or
- Age related dementia
Eating Disorders
Specify Anorexia Nervosa type:
- Restricting type
- Binge eating/purging type
- Atypical
Document Bulimia Nervosa type:
- Bulimia (Hyperorexia nervosa)

14. Insomnia
Specify:
- Primary
- Adjustment
- Paradoxical
- Psychophysiological
- Primary hypersomnia
- Insufficient sleep syndrome
Document if insomnia due to other mental disorder
List other underlying or related conditions:
- Nightmares
- Sleepwalking
Document any contribution from alcohol or drug use on condition, specify name of drug
Major Depressive
Disorder
Document episode:
- Single
- Recurrent
Document severity:
- Mild
- Moderate
- Severe w/o psychotic symptoms
- Severe w/ psychotic symptoms
Indicate status:
- Full remission
- Partial remission
Post-traumatic Stress
Disorder (PTSD)
Document acuity:
- Acute
- Chronic

15. Schizophrenia
Document type:
- Paranoid
- Disorganized
- Catatonic
- Undifferentiated
- Residual
- Other
Differentiate between:
- Schizophrenia
- Schizotypal disorder
- Delusional disorder
- Brief psychotic disorder
- Shared psychotic disorder
Document schizoaffective type:
- Bipolar type
- Depressive type
Substance Use, Abuse and Dependence
Specify:
- Use
- Abuse
- Dependence
Do NOT document 'use' for abuse or dependence
Document any substance induced disorders or complications
Tobacco Use Disorder
- Cigarettes
- Chewing tobacco
Delineate between:
- Tobacco use/abuse
- Tobacco dependence
Document state of dependence:
- In remission
- With withdrawal
- Without withdrawal
Document if used during pregnancy, childbirth, puerperium
Describe history, including product and time