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The DSM-IV codes are being updated to keep them current with the ICD-9-CM diagnostic codes, whose use is mandated by the federal Health Care Financing Administration for purposes of reimbursement under Medicare and required by many other third party payers.
When DSM-IV was published in May 1994, all of the diagnostic codes were compatible with the version of ICD-9-CM that was current at the time. Since then, two years of ICD-9-CM coding revisions have gone into effect, with an additional set of changes to become effective October 1; the updated DSM-IV codes will reflect those changes.
There are two types of coding changes: new diagnostic codes that are being added to the ICD-9-CM system and existing diagnostic codes that have become out-of-date and will no longer be accepted as legitimate codes. (See below for summary of code changes.)
For inpatient hospital bills submitted to HCFA, the new codes become mandatory as of October 1. For physician bills submitted to HCFA, the new codes are not mandatory until January 1, 1997.
All APA members will be sent a brochure introducing the DSM-IV Coding Update and page-by-page instructions on manually updating their copy of DSM-IV.
The DSM-IV Coding Update is available from the American Psychiatric Press, Inc. (APPI) for $10. Copies can be ordered by calling APPI at 1-800-368-5777, or by fax at (202) 789-2648, or by e-mail at order@appi.org.
Additional information about the coding changes is available from Laurie McQueen, APA's DSM-IV Project Coordinator at (202) 682-6391.
Below are coding changes to DSM-IV classification, to be published by APPI this month:291.89 Alcohol-Induced Anxiety Disorder (former code 291.8)
291.89 Alcohol-Induced Mood Disorder (former code: 291.8)
291.89 Alcohol-Induced Sexual Dysfunction (former code: 291.8)
291.89 Alcohol-Induced Sleep Disorder (former code: 291.8)
291.81 Alcohol Withdrawal (former code: 291.8)
293.84 Anxiety Disorder Due to a General Medical Condition (former code: 293.89)
294.1 Dementia Due to HIV Disease (former code: 294.9)
300.82 Undifferentiated Somatoform Disorder (former code: 300.81)
300.82 Somatoform Disorder, Not Otherwise Specified (former code: 300.81)
304.60 Phencyclidine Dependence (former code: 304.90)
312.81 Conduct Disorder: Childhood-Onset Type (former code: 312.8)
312.82 Conduct Disorder: Adolescent-Onset Type (former code: 312.8)
312.89 Conduct Disorder: Unspecified Onset (former code: 312.8)
315.32 Mixed Receptive-Expressive Language Disorder (former code: 315.31)
995.52 Neglect of Child (if focus of attention is on victim) (former code: 995.5)
995.53 Sexual Abuse of Child (if focus of attention is on victim) (former code: 995.5)
995.54 Physical Abuse of Child (if focus of attention is on victim) (former code: 995.5)
995.83 Sexual Abuse of Adult (if focus of attention is on victim) (former code: 995.81)
V61.10 Partner Relational Problem (former code: V61.1)
Physical Abuse of Adult V61.12 (if by partner) (former code: V61.1)
V62.83 (if by person other than partner) (former code: V61.1)
Sexual Abuse of Adult V61.12 (if by partner) (former code: V61.1)
V62.83 (if by person other than partner) (former code: V61.1)
The following are coding changes to DSM-IV Appendix G (Codes for Selected General Medical Conditions and Medication-Induced Disorders):414.00 Atherosclerotic Heart Disease (former code: 414.0)
415.19 Embolism, Pulmonary (former code: 415.1)
278.00 Obesity (former code: 278.0)
575.11 Cholecystitis, Chronic (former code: 575.1)
556.9 Colitis, Ulcerative (former code: 556)
752.51 Undescended testicle (former code: 725.5)
042 HIV infection (symptomatic) (former codes: 042.0-044.0)
(Psychiatric News, September 6, 1996)