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Steps for ICD-10 Compliance

1. DSM is ICD: if you have been using the DSM, you have been using ICD. The DSM is only a guide to picking the right diagnosis code (which are ICD codes). ICD-9 codes have been used for the past 30 years; as of 10.1.15 you must now use an ICD-10 code instead.

See “How Do CPT, ICD and DSM Interact?

 

2. The DSM-5 lists both the ICD-9 and ICD-10 codes, side by side - 299.00 is the ICD-9 code, and F84.0 is the ICD-10 code:


3. You must diagnosis in ICD-10 diagnosis codes for all dates of service 10.1.15 and later.
 


4. The burden is on the provider, not the coder/biller
. Providers must choose from a much bigger pool of possible diagnoses; and it’s a nightmare for the biller to go back to the provider and get the diagnosis code changed on a note. 


5. We offer a ton of resources, tools & information
on our ICD/DSM Resource Center.


6. What did we do in PIMSY?

> Integrated an electronic version of the DSM-5, including both ICD-9 and ICD-10 codes, in PIMSY – and created a crosswalk from the DSM- data.

> Our information has been checked, in detail, by two separate DSM/ICD consultants.

> Because you can change the diagnosis codes, we cannot be held liable and are not responsible for ICD-10 codes. We have provided lots of resources and tools, both within PIMSY and online, but ultimately each practice is responsible for compliance with ICD-10 and other HIT laws.


7. Don’t be fooled by these common myths:

ICD-10 Myth # 1: "I've heard that the government's going to extend the ICD-10 deadline."

ICD-10 Myth # 2: "ICD-10 doesn't affect me because we use DSM-5"

ICD-10 Myth # 3: "I don't need to worry about ICD-10 because my EHR is taking care of it."

ICD-10 Myth # 4: "ICD-10 doesn't apply to me because I work in mental health."

ICD-10 Myth # 5: "I don't need to worry about ICD-10 because I only see self-pay clients."

ICD-10 Myth # 6: "As a provider, I don't need to worry about ICD-10: our billing person's going to take care of it."

ICD-10 Myth # 7: “Workman’s Compensation is going to stay on ICD-9

 

FAQs

How come I'm not seeing in PIMSY exactly what it says in the ICD-10 code book / on icd10data.com / on the Dr. Bob site, etc?

We used the DSM-5; if it’s in the DSM-5, it should be in PIMSY; if not, we did not provide it universally. This is why PIMSY is not showing you what’s in the “ICD-10 manual” – which is typically the WHO coding manual.

We used DSM-5 because that is the CMS-endorsed standard in the United States. DSM-5 does not include certain codes - for example, F84.1, F84.9.

What if I need a code that's not in PIMSY?

There are 2 ways to add diagnosis codes to PIMSY: 1) Add it yourself: you can request your PIMSY Admin to add as many codes as you need via pick lists.

2) Have us add it: create a Help Desk ticket and we will add the codes on the development end. Note that this process may take up to a week. If it's time-sensitive, you will need to add the code(s) yourself. 

How do I change the code in PIMSY to make it closer to what I need?

You can change these codes any time - ask your PIMSY Admin to change the codes as needed by you & your clinicians. 

How can I find the right code in PIMSY?

Follow the instructions here.

Why does PIMSY list so many codes?

There are 2 reasons for this: 1) ICD-10 creates a one-to-many coding situation. That means that what you may have used as one code with DSM-IV/ICD-9 for years is now 20 - or 60 - or 100! different possibilities. ICD-10 creates a lot more specificity, so there might be many more possible "correct" options to choose from.

2) In PIMSY, we have offered you every possible combination of specifier. This was necessary to fulfill the ICD-9 to ICD-10 crosswalk, so each item you might need for diagnosing (including all the specifiers) is offered as a line item.

This will provide you with solid supporting documentation and help protect you with audits. 

9. More Resources:

CMS

Centers for Medicare and Medicaid Services (CMS) ICD-10 Provider Resources

CMS ICD-10 Center

 

APA, AMA, etc

American College of Physicians ICD-10 Resource Center

AAPC Coding Books

APA’s DSM-5

AMA CPT Code Book

World Health Organization WHODAS 2.0

 

Other

icd10data.com

ICD-10 for Behavioral Health blog

ICD-10 Conversion Tool and Resources

Transition to the ICD-10-CM: What does it mean for psychologists?

ICD-10 & DSM-5 Consultant Dr. Jason King: jking@mellivoragroup.com , 801.960.2177

ICD-10 Consultant Lisette Wright: lwright@behavioralhealthsolutionsmn.com , 651.690.0964

ICD-10 Consultant Vince Joyce: info@e3informatics.com , 704.724.5644

 

(Disclaimer: Ultimately, it is the responsibility of each practice to ensure ICD & DSM compliance, including the 10/1/15 ICD-10 transition. PIMSY EMR/SMIS has gathered information from various resources believed to be authorities in their field. However, neither PIMSY EMR/SMIS nor the authors warrant that the information is in every respect accurate and/or complete. PIMSY EMR/SMIS assumes no responsibility for use of the information provided. Neither PIMSY EMR/SMIS nor the authors shall be responsible for, and expressly disclaim liability for, damages of any kind arising out of the use of, reference to, or reliance on, the content of these educational materials. These materials are for informational purposes only. PIMSY EMR/SMIS does not provide medical, legal, financial or other professional advice and readers are encouraged to consult a professional advisor for such advice.)

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