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International Classification of Diseases and Related Health Problems-10 (ICD-10) Codes are Required for Behavioral Health Providers

ICD codes have always been a requirement for filing claims for all providers, including behavioral health providers. 
 
The implementation date for ICD-10 codes is October 1, 2015. All providers must submit an appropriate ICD-10 code to ensure proper claims processing and payment. Failure to use ICD-10 codes for dates of service after October 1, 2015, will result in non-payment.
 
You can continue to use the Diagnostic and Statistical Manual of Mental Disorders (DSM) code for clinical documentation.
 
Differences Between ICD-9 and ICD-10  
The ICD-10 code sets have fundamental changes in structure and concepts that make them very different from ICD-9. There is a new arrangement of categories and alpha-numeric formats.
 
Currently, for behavioral health diagnoses, the ICD-9 and DSM codes are a virtual match. Therefore, in most cases, a DSM code would be acceptable since it would be the same as an ICD-9 code. For example, the code for a single episode of major depressive disorder is 296.2 in both the DSM-4 and ICD-9-clinical modification (CM). The code is F32 in ICD-10.
 
There are approximately 68,000 ICD-10 codes. Keep in mind that your practice will use a minimal number of codes.
 
To prepare for ICD-10, Companion Benefit Alternatives (CBA) encourages you to:
  • Purchase applicable resource materials from the American Medical Association and American Psychiatric Association, such as the DSM-5 manual, which includes the ICD-10 code for each DSM code. 
  • Contact all providers, payers, software vendors, clearinghouses and other billing services to ensure they are on track to be compliant by the October 1 implementation date.
  • Ask your service vendors if they have been involved in testing so they can detect any issues prior to the transition.
Please note: covered entities should not use the new codes prior to October 1, 2015.
 
For more information, please contact your provider contract specialist at 800-868-1032, ext. 25538 or ext. 25731. We appreciate your continued service to our members. If you have questions or concerns, please email us at cba.provrep@companiongroup.com.

Visit our website at www.CompanionBenefitAlternatives.com.

 
Copyright © 2015 Companion Benefit Alternatives, All rights reserved.


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