Transitioning to the ICD-10-CM

By Julia Besser, M.A. and Lynn Bufka, Ph.D.
July 30, 2015



no-health-insurance-300x203Psychologists and other health professionals have a fast-approaching deadline to contend with in their already busy schedules. The U.S. Department of Health and Human Services (HHS) issued a final ruling that Oct. 1 is the mandatory compliance date for all entities subject to the Health Insurance Portability and Accountability Act (HIPAA) requirements to transition to the ICD-10-CM.

On this date, the ICD-10 coding classification will become the new baseline for clinical data, clinical documentation, claims processing and public health reporting. At this time there is no indication that a delay or extension will be presented:  Beginning Oct. 1, claims filed using prior versions of the codes from the ICD-9-CM will be denied as unprocessable.

With nearly five times as many codes as the previous version, the ICD-10-CM proves beneficial for psychologists as more specificity will be routinely captured in diagnoses. This can lead to greater individualized care, advanced treatment planning, superior care coordination across fields and improved reliability in research settings.

However, with the increased diagnostic nuances come a significant administrative learning curve as well. The American Psychological Association Practice Organization (APAPO) has developed several resources to assist members in creating a smooth transition to the new coding system. Three basic steps are recommended to help with the transition.

The first component is understanding how the basic structure of the upcoming ICD-10-CM varies from the current structure of the ICD-9-CM. Psychologists will typically use Chapter 5 entitled Mental, Behavioral and Neurodevelopmental Disorders. However, disorders related to amnesia and care-provider dependencies, for example, are not found in this behavioral health chapter.

Familiarity should also be developed with Chapter 6 (Diseases of the Nervous System), Chapter 18 (Symptoms, Signs and Abnormal Clinical and Laboratory Findings, not otherwise classified) and Chapter 21 (Factors Influencing Health Status and Contact with Health Services). And those working in other areas of health will want to become familiar with any additional relevant chapters.

While the former version of the ICD had a mostly numeric structure, the ICD-10-CM utilizes an alphanumeric coding structure. For example, previously the code for Post-Traumatic Stress Disorder was simply 309.81. The new coding could be either F43.10, F43.11 or F43.12. Each component of the code refers to specific diagnostic information. The letter “F” in this new code refers to the chapter “Mental, Behavioral and Neurodevelopmental Disorders,” while the “43” refers to the section “Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders.” Finally, the numbers following the decimal point refer to specifiers such as “acute” or “chronic.” Further information on coding structure can be found at apapracticecentral.org.

The second recommended transitional step is to take advantage of the many resources provided for making a successful conversion. The ICD-10-CM Tabular List of Diseases and Injuries is made available for free online via the Centers for Disease Control and Prevention (CDC). This is an easily navigated document that includes all chapters, subsections and associated codes.

Alternatively, several ICD-9-CM to ICD-10-CM code conversion websites are available for free public access. One such site is ICD10Data.com. It is important to note that these websites are not sanctioned by the CDC and should not be the sole source for establishing the accuracy of conversion data.

The American Psychological Association and APAPO are committed to being a resource for information regarding this upcoming transition. An APA publication entitled “A Primer for ICD-10-CM Users: Psychological and Behavioral Conditions” was specifically created to assist mental health professionals by providing a thorough overview and detailed instructions on navigating the new system.

This resource can be purchased via apa.org/pubs/books/4317336.aspx. APAPO members have free access to a web-based ICD-10-CM application. This portal includes the ability to search by keyword, navigate categories of diagnoses or even explore graphical interfaces. Further details can be found at apapracticecentral.org/update/2014/12-18/member-benefit.aspx.

Members are also encouraged to contact the APA Practice Directorate’s Office of Practice Research and Policy with further questions via e-mail at SPracticeResearchandPolicy@apa.org or by phone: 800-374-2723, ext. 5911.

Julia Besser, M.A., is a former humanitarian aid worker earning her Ph.D. in psychology with a focus on corrections and policy making. She teaches undergraduate coursework in psychopathology and serves as a graduate senator at Texas Woman’s University. She is also currently a research and policy intern with the American Psychological Association.

 Lynn F. Bufka, Ph.D., is an associate executive director in the Practice Directorate of the APA and heads the Practice Research and Policy Office. She is a licensed clinical psychologist. Comment or questions may be addressed to SPracticeResearchandPolicy@apa.org.

Editors note: In the print version of this issue there is an article that includes other resources for ICD-10-CM related materials.

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