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.
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