ICD-10-CM REFERENCE TOOL

(T.Cipriano, 2015)

Get Ready to Use ICD-10-CM Codes for Billing as of October 1st!

As you already know, providers and insurance companies are required to use ICD-10-CM for billing as of October 1st. With a few resources at your fingertips, you will be good to go.

The most up-to-date ICD codes and Clinical Guidelines can be downloaded for free from the CDC website.

For the most part, you will only need Chapter V: Mental and Behavioral Disorders, which are “F” codes (begin with the letter “F”, see below). Click here to download ICD-10-CM Chapter V. Neurological disorders are included in ICD-10-CM Chapter VI and are prefaced with a “G” code.

The ICD-10-CM 2016 Official Guidelines for Coding and Reporting provide very useful and user-friendly guidelines for working with the ICD. For a copy of the Guidelines, click here.

  • For example, on page 10, the Guidelines explain the differences between “Excludes 1” (not coded here; in other words, cannot be diagnosed simultaneously with this code, cannot co-occur) and “Excludes 2” (not included here; in other words not considered part of this diagnosis but can be simultaneously diagnosed using a different code, can co-occur).

FROM DSM-5 TO ICD-10

The ICD-10 coding system is alphanumeric rather than numerical. All mental health diagnostic codes are found in Chapter V of ICD-10, and all codes begin with the letter “F”. The “F” indicates that the diagnostic code is classified with mental, behavioral and neurodevelopmental disorders.

  • Example: DSM-5 296.42 – Bipolar Disorder, most recent episode manic, moderate directly converts to ICD-10-CM F31.12

DSM-5 includes a crosswalk to ICD-10 for all DSM diagnoses, with the ICD-10 code in parentheses to the right of the DSM-5/ICD-9 code.

DSM-5 is not an exact match to ICD-10.

  • ICD-10-CM offers more diagnostic categories than DSM-5, so not only may the ICD-10-CM approximation given in the DSM-5 not be a good match with the DSM-5 diagnosis you are considering, but also the ICD-10 may contain a diagnostic category which is more specific and directly relevant to your patient. Experts tell us only about 50% of the ICD-10 codes have been adopted by DSM-5. Some examples of codes left behind by DSM-5 include:
  • Panic Disorder and Agoraphobia. ICD-10 still recognizes Panic Disorder with Agoraphobia, while DSM-5 separates Panic Disorder and Agoraphobia as 2 distinct, stand-alone diagnoses.
  • Asperger’s Disorder. ICD-10 continues to list Asperger’s Disorder, along with clinical descriptions and diagnostic criteria. Asperger’s Disorder as a stand-alone diagnosis has been eliminated from DSM 5 and has been replaced within the more general Autism Spectrum Disorder.
  • Substance Abuse and Dependence. DSM-5 eliminated the distinction between substance abuse and substance dependence, whereas the ICD-10 retains both categories. There are also many more substance abuse and dependence diagnostic choices in the ICD-10. For example, ICD-10 offers 44 diagnostic possibilities for cannabis abuse or dependence.
  • Mixed Anxiety and Depression Disorder (used when neither anxiety nor depression predominates); ICD-10 uses code F41.2 but it is not included in DSM 5.
  • More generally, the “F30’s” in the ICD-10 offer more coding choices for mood disorders than DSM-5, which may enable you to better represent a patient’s depressive symptoms.

While a crosswalk for an ICD code is provided with all DSM-5 diagnoses, the ICD coded disorder may be different from the DSM diagnosis. As Greg Neimeyer, PhD recently explained at a CPA-sponsored ICD-10-CM workshop, the DSM-5 provides a blunt crosswalk to ICD-10 codes, with a gross approximation of a given disorder.

RESOURCES

Crosswalks:

DSM-5

  • The DSM-5 offers a crosswalk to ICD-10-CM codes for all diagnoses. This is a good option for the most part. You can order a discounted copy of DSM-5 from or
  • As noted above, many DSM-5 codes match up perfectly with ICD-10, but many do not. The DSM-5 crosswalk will give you the closest approximation.

ICD10data.com

  • ICD10data.com is a good resource. ICD10data.com’s homepage states that the website is mobile-friendly and compatible with both smartphones and tablets.
  • You can simply type in an ICD-9 or DSM code into the search bar at the top of the page, and you will be brought to the appropriate ICD-10 code.
  • For example, if you type in 300.02 (Generalized Anxiety Disorder), you will learn that it converts directly to ICD-10-CM F41.1 (Generalized Anxiety Disorder).
  • If you click on F41.1, you get additional information, including whether it is a billable code.

Books

Goodheart, C. Primer for ICD-10-CM users A concise, 160 page, spiral-bound reference book. Pragmatics plus all of the ICD-10-CM Chapter V codes.

AMA, ICD-10-CM Professional Reference. Includes all chapters of the ICD-10-CM, over 1000 pages.

Apps

Apple app called “Find a Code”.

Other

Ed Zuckerman’s “Clinician’s Toolbox” ( CliniciansToolBox.com) now has a 12 page laminated Reference List of Psychiatric Diagnoses for ICD-10-CM.