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ICD - 10 Info

The Countdown to October 1st and ICD-10 is happening… we all need to be ready, although there are discussions of delays and a possible  ICD-11,  ICD-10 is coming along with all the changes it means for us.

What Is ICD-10?

On October 1, 2015, medical coding as we know it will change forever. Everyone covered by the Health Insurance Portability and Accountability Act (HIPAA) must be compliant with ICD-10 on that date—not just those who submit to Medicare and Medicaid.


Below are some examples of changes and resources..

ICD-9            ICD-10


Diagnosis Codes are 3-5 characters

Codes are 3-7 characters

Approximately 14,000+ codes

69,000+ codes

First character is numeric or alpha (E or V) and characters 2-5 are numeric

First character is alpha, characters 2 and 3 are numeric, 4-7 are
alpha or numeric

Difficult to analyze data due to nonspecific codes

Expanded to allow more specificity and accuracy resulting in improved data analysis

No other country uses ICD-9— limiting interoperability with other countries

United States is one of last major countries to transition to ICD-10


More Examples of Changes for Mental Health:

In addition to these broader changes, there are several specific areas where ICD-10-CM differs for mental health providers.

4 Mental and behavioral disorders due to psychoactive substance use (F10-F19). Although ICD-9-CM doesn’t distinguish between use, abuse and dependence, ICD-10-CM does. Many of the codes in this section also specify complications such as mood disorders, delusions, delirium, perceptual disturbances, and more.

The ICD-10-CM guidelines have also been expanded to include a hierarchy for reporting purposes. Providers can only submit one code per substance (e.g., alcohol, opioid, cannabis, etc.). This hierarchy states the following:

• If the patient uses and abuses the same substance, assign only the code for abuse. 

·         If the patient abuses and is dependent on the same substance, assign only the code for the dependence.

·         If the patient uses, abuses, and is dependent on the same substance, assign only the code for the dependence.

·         If the patient uses and is dependent on the same substance, assign only the code for the dependence.

Mental health providers must clearly document the association of the psychoactive substance with the patient’s mental or behavioral disorder.

4 Pain disorders related to psychological factors (F45.4-). The ICD-10- CM guidelines have been expanded to include information related to codes F45.41 (pain disorder exclusively related to psychological factors) and F45.42 (pain disorder with related psychological factors). Although these two codes seem very similar, providers should note the following:

·         Code F45.41 denotes purely psychological pain that is not supported by any medical condition.

·         Code F45.42 denotes a legitimate medical pain with a psychological component. When reporting this code, providers should also report the associated acute or chronic pain (G89.-). Note that pain NOS is reported with R52.

4 Attention deficit hyperactive disorder (ADHD) (F90.-). ICD-10-CM has been expanded to include the specific type of ADHD (i.e., predominantly inattentive, predominantly hyperactive, or combined). This code expansion, like many others, will be important in terms of research and treatment.

4 Anorexia. ICD-10-CM includes separate codes for anorexia nervosa, unspecified (F50.00), anorexia nervosa, restricting type (F50.01), and anorexia nervosa, binge eating/purging type (F50.02). In ICD-9-CM, anorexia nervosa only had one code (307.1) 










Your LACPA Board is keeping a watchful eye and will continue to send updated information.





Evelyn Pechter, PsyD

Clinical Psychologist • PSY21132

(310) 622-5741

LACPA Board of Directors/Treasurer


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