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You’ll need to use the appropriate diagnosis code along with your assessment, clinical impression, and plan of care in your documentation. All payers use and require ICD-10 codes in claims. The ICD-10 should serve as your diagnostic bible for billing. The fifth edition of the DSM tries to mitigate the confusion with ICD-10 codes by referencing the ICD codes, but because the DSM-5 and ICD-10 aren’t strictly related, there are sometimes disconnects between criteria in diagnoses in the two sets of codes. It helps therapists to determine the best possible path for treatment. It also serves to provide clinicians with a common language for communication and research. The DSM-5 is a vital tool to assist therapists in identifying, diagnosing, and describing mental disorders. ICD-10: Diagnostic Codes for Mental Health Next, we’ll explain why you shouldn’t use these codes for billing. But what makes the DSM-5 confusing is that it also contains diagnoses codes.
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An ICD-10 code essentially tells payers why you provided a patient with the services you did.ĭSM-5 Codes - All therapists are familiar with the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is the handbook used by health care professionals as the authoritative guide to the diagnosis of mental disorders. These codes describe diseases, signs and symptoms, abnormal findings, complaints, and external causes of injury or diseases. then developed a clinical modification (ICD-10-CM) for medical diagnoses based on the WHO’s ICD-10 set. ICD-10 Codes - The World Health Organization (WHO) publishes and updates the IDC-10 code set. CPT codes are used in the claims submission process to tell payers what procedures you need reimbursement for. These codes describe tests, evaluations, treatments, and any other medical procedure performed by a healthcare provider for a patient.
You’ll want to know what the differences are between each and what they’re used for.ĬPT Codes - The Current Procedural Terminology (CPT) code set is published and maintained by the American Medical Association (AMA). Let’s start by looking at the three primary types of mental health codes: CPT, ICD-10, and DSM-5.
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We’ll also share how to find out what you can expect for reimbursement rates so you have a better idea of what your revenue will be.
In this guide, we’ll cover what you need to know about CPT, ICD-10, and DSM-5, as well as common coding mistakes therapists make when billing. Eventually, coding will become second nature. Once you see how the codes work, it will be much easier to determine what codes to use when. While billing codes can be complex, there’s no reason you can’t master them. Understanding mental health billing codes will help you optimize your billing so you can focus on what matters most: providing quality care to your clients.
Billing accurately, in a timely manner, ensures you get paid what should be for the services you’re providing and creates reliable cash flow for your business. Mental health billing codes can be overwhelming.Īt the same time, having a firm grip on billing is one of the best things you can do for the health of your practice. not only are there multiple sets of codes, but there are also detailed rules around which codes should be used for what services. Billing is intimidating for many therapists due to the complexity of coding.
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