Behavioral Health in ICD-10-CM – Features and Top Codes

by | Published on Dec 11, 2015 | Specialty Coding

Behavioral Health
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Medical coding for mental and behavioral disorders in ICD-10-CM is different from that of ICD-9. Though some ICD-10 codes mirror ICD-9, there is expanded granularity for certain categories. More specific clinical documentation is required in such cases to choose the most appropriate ICD-10 code. Let’s take a look into the major features of the new coding system.

If ICD-9 code had five characters, ICD-10 medical code has seven characters. When the first three characters represent category and the last two characters represent etiology, anatomic site and manifestation in ICD-9, the first three characters represent category, the next three characters represent etiology, anatomic site and severity and the last character represents episode of care (initial, subsequent, sequela) in ICD-10. The other major features of ICD-10 include:

  • The total number of codes increased from 14,000 (ICD-9) to 69,000 (ICD-10) as a result of increased specificity. However, the number of codes does not increase for all diagnoses. For example, 56 Schizophrenia related codes in the ICD-9 code set has been reduced to 11 codes in ICD-10.
  • Every ICD-10 code for behavioral health starts with ‘F’ and 50% of codes are related to the musculoskeletal system.
  • Critical classification changes to substance use and dependence including drug ‘use’ vs. ‘dependence’ vs. ‘abuse’).
  • ICD-10 is distinguished by greater precision in identifying childhood disorders.

Top ICD-10 Codes for Behavioral Health

The top most used ICD-10 codes, when it comes to behavioral medical coding are as follows (along with ICD-9 to ICD-10) transition.

ICD-9 ICD-10
296.33: Major Depressive Disorder F33.2: Major depressive disorder, recurrent severe without psychotic features
296.90: Mood Disorder NOS F39: Unspecified mood (affective) disorder
300.00: Anxiety Disorder NOS F41.9: Anxiety disorder, unspecified
303.90: ETOH Dependence F10.20: Alcohol dependence, uncomplicated
304.80: Polysubstance Abuse F19.20: Other pyschoactive substance dependence, uncomplicated
305.20: Marijuana Abuse F12.10: Cannabis abuse, uncomplicated
305.50: Opiate Abuse F11.10: Opioid abuse, uncomplicated
305.60: Cocaine Abuse F14.10: Cocaine abuse, uncomplicated
F14.120: Cocaine abuse with intoxication, uncomplicated
F14.121: Cocaine abuse with intoxication with delirium
F14.122: Cocaine abuse with intoxication with perceptual disturbance
F14.129: Cocaine abuse with intoxication, unspecified
305.70: Amphetamine Abuse F15.10: Other stimulant abuse, complicated
F15.120: Other stimulant abuse with intoxication, uncomplicated
F15.121: Other stimulant abuse with intoxication, delirium
F15.122: Other stimulant abuse with intoxication, with perpetual disturbance
F15.129: Other stimulant abuse with intoxication, unspecified
307.1: Anorexia F50.00: Anorexia nervosa, unspecified
F50.01: Anorexia, nervosa, restricting type
F50.02: Anorexia nervosa, binge eating/purging type

Julie Clements

Julie Clements, OSI’s Vice President of Operations, brings a diverse background in healthcare staffing and a robust six-year tenure as the Director of Sales and Marketing at a prestigious 4-star resort.

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