That One Thing Every Behavioral Health Provider is Worried About This Year

If you weren’t one of the 400 attendees at our “ICD-10” webinar this week, you missed out on a wonderful learning opportunity from Lisette Wright, independent consultant with Behavioral Health Solutions, P.A.

Lisette Wright, M.A.

If your behavioral health/human services organization is a HIPAA entity (yes, it is), you need actionable information to help you prepare for the transition from ICD-9 to ICD-10. The transition to ICD-10 is mandatory effective October 1, 2014. Will you be ready?

Lisette was able to explain why the change is such a big adjustment for those who diagnose:

• ICD-10 requires far more specificity and details in the documentation to support the diagnosis.
• There are no exact crosswalks between code sets
• Transitioning to the ICD-10 code set will require clinical judgement, thought, and a little more time.
• Some payers may still require DSM codes for prior authorizations

Lisette also included this very helpful diagram and explanation of the ICD-10 “F code” format:

• Chapter F = Chapter 5 in ICD-10
• Category = condition or drug of choice
• Last 4 digits represent the clinical state: etiology, severity, manifestation and placeholders

Note: Some T codes, Y codes, and R codes are applicable to SU diagnosing (T50.905= Adverse effect of unspecified drugs, medicaments and biological substances).

Also very helpful were Lisette’s tips for preparing for the Clinical Documentation Implications:

• Prepare staff that changes are coming and how they need to document
• Medical Necessity and Documentation Improvements
• Higher level of specificity and new policies, procedures and expectations
• Will require training of staff in new workflows and processes; use of diagnostic language and criteria in record

Listette also provides consulting services to providers to help them transition to ICD-10. If you would like to contact Lisette, you can reach her though her website and via email.