Coding mental disorders
Mental retardation (MR) is a generalized disorder, characterized by significantly impaired cognitive functioning and deficits in two or more adaptive behaviors that appears before adulthood. It has historically been defined as an Intelligence Quotient score under 70.
Coding mental disorders is complicated by the availability of another set of widely used codes, the Diagnostic and Statistical Manual, Fourth Edition (DSM-IV). According to this latest edition three criteria must be met for a diagnosis of mental retardation:
1. an IQ below 70,
2. significant limitations in two or more areas of adaptive behavior (as measured by an adaptive behavior rating scale, i.e. communication, self-help skills, interpersonal skills, and more), and
3. evidence that the limitations became apparent before the age of 18.
Coders are advised to use DSM-IV as a reference aid to arrive at a diagnosis, but ICD-9-CM should be used for the actual coding. The Mental Disorders section of ICD-9-CM was developed with the assistance of the American Psychiatric Association in an effort to help coders apply these diagnostic codes accurately. The codes are recognized by payers and help avoid confusion and claim denials.
ICD – 9 – CM codes for Mental disorders (290 – 319)
Please refer Inpatient Psychiatric Benefit Days Reduction and Lifetime Limitation from Medicare Benefit Policy manual.
Popular Posts
-
Modifier - as the name implies a modifier will modify a service / procedure or an item under certain circumstances for appropriate reimbur...
-
An OPPS payment status indicator is assigned to every HCPCS code. The status indicator identifies whether the service described by the H...
-
Therapeutic activities are considered medically necessary for patients needing a broad range of rehabilitative techniques that involve ...
-
Mohs surgery, also known as chemosurgery, created by a general surgeon, Dr. Frederic E. Mohs, is performed to remove complex or ill-defi...
-
Ambulance transportation is a covered service when the patient’s condition is such that the use of any other method of transportation would...
-
AAPC’s Certified Professional Coder (CPC) credential is the gold standard for medical coding in physician office settings and held by more ...
-
Claim Adjustment Reason Codes (CARC) CO-22 or PR-22 This care may be covered by another payer per coordination of benefits. CO-19 This is...
-
This procedure is medically necessary only when it requires the professional skills of a therapist, is designed to address specific ne...
-
Effective for claims processed with dates of service (DOS) on or after January 1, 2018, influenza virus vaccine code 90756 (Influenza v...
-
A bacterial urine culture is a laboratory procedure performed on a urine specimen to establish the probable etiology of a presumed urina...