> “Where/how did PIMSY get these codes?”
We got them directly from the DSM-5 and then had them checked by 2 different ICD-10/DSM-5 consultants (Vince Joyce and Dr. Jason King)
> “Why are the codes in PIMSY not exactly what I’m seeing in my “ICD-10 manual / on icd10data.com, etc”?
There are many, many different versions of the codes: ie, WHO, DSM and CMS all have slightly different wording and options. We chose to use DSM-5, so what they see on the WHO “ICD manual, icd10data.com, etc, etc.” might look a little different.
> “Should I be concerned if the code descriptions don’t match exactly?”
That’s up to you: if you don’t feel comfortable using the descriptions we’ve offered, you can change, edit, delete or enhance what we’ve provided. We have offered you a very detailed, CMS-endorsed standard; what you do with it is up to your practice.
> “Is PIMSY ‘wrong’ because the descriptions don’t match exactly?”
No; we used the DSM-5 because it’s the CMS-endorsed & required standard for mental health in the US. The codes are correct and have passed testing; the variance is in the descriptions, which should only come into play during an audit as supporting documentation.
> “How do I find the right code in PIMSY?”
Follow the steps here.
> “Why are certain codes not in PIMSY (ie, F84.1, Atypical Autism)?”
There are codes in the WHO ICD-10 manual or other resources that DSM-5 does not endorse/recognize (ie, F84.1, Atypical Autism). We used the DSM-5 because it’s the CMS-endorsed & required standard for mental health in the US, but if you need or want codes that’s aren’t in DSM-5 / PIMSY, all you have to do is add them (or request us to add them by emailing firstname.lastname@example.org – note there may be a few days lag time if we add the codes.)
> “What do I do if I’m not seeing a code that I need?”
Have your PIMSY Admin add the code. What we have provided you is an accurate and detailed standard list, taken directly from the DSM-5. You are welcome to add, edit, delete, ignore, or otherwise use what we’ve provided as you see fit / need. You may also email email@example.com to have us add them, but note there may be a few days lag time if we add the codes.
> “What if what I’m seeing in my DSM-5 manual doesn’t match what’s in PIMSY?”
1. Make sure that you’re taking into account the DSM-5 updates: there were code changes issued after the manual was printed, and what’s in your printed manual may not be accurate/correct. See page 3 here for the updates.
2. If it’s still not correct, please email firstname.lastname@example.org to create a Help Desk ticket so we can update.
> Why are there so many code options on the coding list? Ie, 192 different line items/options for F84.0, Autism Spectrum Disorder?
The coding list provides every possible combination of specifier in the description. For example, for F84.0, Autism Spectrum Disorder, you must document the following specifiers: Specify if: associated with a known medical or genetic condition or environmental factor; Associated with another neurodevelopmental, mental, or behavioral disorder. Specify if: current severity for Criterion A and Criterion B: Requiring very substantial support, Requiring substantial support, Requiring support. Specify if: With or without accompanying intellectual impairment, With or without accompanying language impairment, With catatonia (use additional code 293.89 [F06.1]).
Instead of 1 line item for F84.0, Autism Spectrum Disorder, there are therefore 192 line items! That’s how many different rows are needed to provide you with every possible combination of specifier necessary for supporting documentation.
> “We’ve been using DSM; what do we do now?”
If you’ve been using DSM, you’ve been using ICD-9 codes: DSM is a guide to picking the right ICD code. All providers must use ICD-10 codes for all dates of service 10.1.15 and beyond. You should be using the DSM-5 to diagnose, and it will direct you to the correct ICD-10 code. You can then find this ICD-10 code in PIMSY.