In October, 2015, the World Health Organization’s International Classification of Diseases (10th Ed., or ICD10) becomes the universal classification system for all treatable disorders. Essentially, anyone who treats HIPAA covered patients (almost everyone), and providers who bill major insurers, submit claims to Medicare, or other federal agencies like TRICARE are required to use ICD diagnostic codes when submitting billing. Full instructions, including a crosswalk from ICD9 to ICD10 can be found on the Centers for Medicare and Medicaid Services ICD10 website (http://www.cms.gov/Medicare/Coding/ICD10).
Although in the past it was variably acceptable to use the American Psychiatric Association’s (aPa) Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSMV) for coding and billing purposes, this is no longer the case. Most insurors will now accept only ICD10 codes. Unfortunately, at this time no DSMV-ICD10 crosswalk is generally available.
ICD10 is available in downloadable form from the World Health Organization (WHO) at the following website: www.who.int/classifications/icd. Unlike the DSMV, which costs approximately $200 and is copyrighted by the aPa, the ICD10 is in the public domain. Training manuals for the ICD10 are also available on the WHO’s website, and provide guidance and interpretation on each code.
As you’re aware, the DSMV has been widely criticized for a broad expansion of classification of disorders previously considered variants on normal behavior. ICD10’s categorizations are more circumscribed, but the ICD10 has also been criticized for an excessive focus on pathology. Critics argue that it provides nothing that would allow clinicians to systematically assess a patient’s areas of strength that my by improved by systematic intervention, or at least understood in the context of a patient’s illness. In response, the WHO in 2013 published the International Classification of Functioning, Disability, and Health (ICF), available at www.who.int./classifications/icfupdates.
As of this writing, the ICF has been incorporated into the public health schemes of a small handful of (mostly European) countries. While remaining largely an aspirational document, it is eliciting vigorous conversation on how to incorporate standard assessments of strengths as well as weaknesses into a treatment plan.
The author is Executive Officer of the National Register of Health Service Psychologists.