DSM-V – ICD-10
DSM-V – ICD-10Benjamin F. Miller, PsyDAssistant ProfessorDepartment of Family MedicineUniversity of Colorado School of Medicine
ContextHEALTHCARE LANDSCAPE
Context Fragmentation is driving inefficiency andineffectiveness in healthcare The divide between mental health andphysical health is closing The DSM-V has just recently been releasedleaving many questions for the field
Mental health classification Currently mental health professionals have twoclassification systems to use for coding mentaldisorders: (1) the International Classification ofDiseases (ICD) and (2) the Diagnostic andStatistical Manual of Mental Disorders (DSM) The DSM-IV provides diagnostic codes solely formental disorders; whereas the ICD-10-CM hascodes for both physical and mental disorders CMS has addressed DSM/ICD connection
DSM-V & ICD-10COMPARISON
DepressionDSM-VICD-10Depressed mood and/or loss of interest orpleasure in life activities for at least 2 weeksand at least five of the following symptomsthat cause clinically significant impairment insocial, work, or other important areas offunctioning almost every day: 1.Depressed mood most of the day. 2.Diminished interest or pleasure in all ormost activities. 3.Significant unintentional weight loss orgain. 4.Insomnia or sleeping too much. 5.Agitation or psychomotor retardationnoticed by others. 6.Fatigue or loss of energy. 7.Feelings of worthlessness or excessiveguilt. 8.Diminished ability to think orconcentrate, or indecisiveness. 9.Recurrent thoughts of deathIn typical depressive episodes of all threevarieties described below (mild (F32.0),moderate (F32.1), and severe (F32.2 andF32.3)), the individual usually suffers fromdepressed mood, loss of interest andenjoyment, and reduced energy leading toincreased fatiguability and diminished activity.Marked tiredness after only slight effort iscommon. Other common symptoms are: (a)reduced concentration and attention; (b)reduced self-esteem and selfconfidence; (c)ideas of guilt and unworthiness (even ina mild type of episode); (d)bleak and pessimistic views of thefuture; (e)ideas or acts of self-harm or suicide; (f)disturbed sleep (g)diminished appetite.
Other differencesDSM-VICD-10 Produced by a single nationalprofessional association forpsychiatrists (the AmericanPsychiatric Association) Generates revenue for theAmerican PsychiatricAssociation DSM is developed primarily byU.S. psychiatrists DSM is approved by theassembly of the AmericanPsychiatric Association Produced by a global healthagency with a public healthmission to help countriesreduce the disease burden ofmental disorders ICD is available free on theInternet (WHO not for profit) ICD's development is global,multidisciplinary, andmultilingual ICD is approved by the WorldHealth Assembly
What role for the DSM in mental health?CONNECTION
Summary ICD is the HIPAA complaint code set DSM-V was released at the APA annual meetingMay 18th and ICD 9/10 codes listed in DSM-V The DSM continues to predominately be used bymental health providers It remains unclear as to how the DSM-V will bereceived in healthcare There appears to be some confusion about therole of DSM-V and ICD-10 for mental healthprofessionals
Thank you Benjamin F. Miller, PsyD Benjamin.miller@ucdenver.edu
ICD is the HIPAA complaint code set DSM-V was released at the APA annual meeting May 18th and ICD 9/10 codes listed in DSM-V The DSM continues to predominately be used by mental health providers It remains unclear as to how the DSM-V will be received in healthcare There appears to be some confusion about the
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Using DSM-IV, you make a diagnosis of alcohol abuse. Using DSM-5, you make a diagnosis of alcohol use disorder, mild. ICD-9-CM DSM-IV dx –305.00 ICD-9-CM DSM-5 dx –305.00 ICD-10-CM DSM-5 dx –F10.10 DSM-IV Substance abuse crosswalks to mild SUD in DSM-5. Substance dependence crosswalks to moderate
ICD-9 724.02 ICD-10 M48.06 Spinal stenosis, lumbar region ICD-9 720.2 ICD-10 M46.1 Sacroiliitis, not elsewhere classified ICD-9 724.8 ICD-10 R29.898 Other symptoms and signs involving the ** musculoskeletal system ICD-9 721.42 ICD-10 M47.16 Other spondylosis with myelopathy, lumbar region ICD-9 723.1 ICD-10 M54.2 Cervicalgia ICD
More on ICD-10. ICD-10-PCS replaces ICD-9-CM inpatient procedure coding: ICD-9-CM procedure codes 3 to 4 numeric digits ICD-10-CM codes 7 alphanumeric digits ICD-10-PCS code format substantially different from ICD -9 Unlike ICD-9, ICD-10
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familiar with DSM-IV-TR, its content, and its use. This presentation is solely to facilitate transition from DSM-IV-TR to DSM-5 and is not intended to be a basic course on DSM-5. DSM-5:Classification, Criteria, and Use DSM-5 Revisions: Brief History and Conceptual Approaches ICD-8-9 and DSM-II 1967-1972 US-UK study:
DSM-IV Description DSM 5 Classification DSM- 5 CODE/ ICD 10 CODE DSM-5 Description Somatoform . Disorders . F44.4. Formerly Factitous Disorder . 300.81 . Somatization Disorder . Undifferentiated Somatoform Disorder . Somatic Symptom . a
