[pshrinkery, healthcare] But the man with two coding systems never knows what diagnosis it is
(1)
So... apparently the DSM5 has the ICD-10 code(s) for schizophrenia wrong.
If you look up schizophrenia in the DSM5 - say, because you want to bill for treating a patient for schizophrenia and would like to know what ICD-10 code to bill that with - you will find all of two ICD-10 codes. Right there in the title of the section it says "F20.9". Later on in the section, it explains there's this special code for an edge case with catatonia. That's it. Those are your two coding options, as per DSM5.
If you have a patient with schizophrenia, the DSM5 tells you to code it "F20.9".
According to the ICD10, apparently, which I don't have a copy of because mental health, "F20.9" is "schizophrenia, unspecified", and payers are bouncing those bills the way brick walls bounce tennis balls fired from a cannon. This is because "unspecified" is the new "NOS". Not to be confused with "F20.89 Other schizophrenia". Which they probably also bounce.
Clinicians: Here is a convenient list of ICD10 schizophrenia codes. The default code for schizophrenia without a subtype is "F20.3": "Undifferentiated schizophrenia".
I note that we are being reduced to using some random website on the internet for our authority on ICD10 codes, but it's all we got.
(2)
The fine people who notified me and my colleagues about the previous snafu have also notified us that Generalized Anxiety Disorder (GAD, F41.1) has to some extent stopped working, and we are not to use it any more.
Since GAD is a pretty conventional and common diagnosis, I went to ask for clarification.
Apparently some number of our payers - commercial ones? - have decided that GAD is only worth 12 therapy sessions per year.
I don't know if this is a universal thing or what, but, again, at one of the clinics I work at, we were told to stop diagnosing patients with GAD and find something else to diagnose them with, if we want to get paid to treat them.
If it is a thing and if you have GAD, expect soon to have a discussion with your treater about new research which shows your symptoms are actually much more characteristic than previously thought of something more reliably reimbursable.
So... apparently the DSM5 has the ICD-10 code(s) for schizophrenia wrong.
If you look up schizophrenia in the DSM5 - say, because you want to bill for treating a patient for schizophrenia and would like to know what ICD-10 code to bill that with - you will find all of two ICD-10 codes. Right there in the title of the section it says "F20.9". Later on in the section, it explains there's this special code for an edge case with catatonia. That's it. Those are your two coding options, as per DSM5.
If you have a patient with schizophrenia, the DSM5 tells you to code it "F20.9".
According to the ICD10, apparently, which I don't have a copy of because mental health, "F20.9" is "schizophrenia, unspecified", and payers are bouncing those bills the way brick walls bounce tennis balls fired from a cannon. This is because "unspecified" is the new "NOS". Not to be confused with "F20.89 Other schizophrenia". Which they probably also bounce.
Clinicians: Here is a convenient list of ICD10 schizophrenia codes. The default code for schizophrenia without a subtype is "F20.3": "Undifferentiated schizophrenia".
I note that we are being reduced to using some random website on the internet for our authority on ICD10 codes, but it's all we got.
(2)
The fine people who notified me and my colleagues about the previous snafu have also notified us that Generalized Anxiety Disorder (GAD, F41.1) has to some extent stopped working, and we are not to use it any more.
Since GAD is a pretty conventional and common diagnosis, I went to ask for clarification.
Apparently some number of our payers - commercial ones? - have decided that GAD is only worth 12 therapy sessions per year.
I don't know if this is a universal thing or what, but, again, at one of the clinics I work at, we were told to stop diagnosing patients with GAD and find something else to diagnose them with, if we want to get paid to treat them.
If it is a thing and if you have GAD, expect soon to have a discussion with your treater about new research which shows your symptoms are actually much more characteristic than previously thought of something more reliably reimbursable.