1. Forum: Procentive User Community
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Interns

linda 8 years ago in Clinical Charting Module • updated 8 years ago • 6

We have interns/ADT. How do you handle signing off on the medical record when you should have two signatures?

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DSM 5 vs. ICD_10 - How are they different?

Katie Sandquist 9 years ago in ICD-10/DSM5 • updated 9 years ago • 0
Diagnostic Criteria is set list of principles or standards that is used in the identification of diseases by the examination of the symptoms and signs and by other investigations.

DSM 5 (The Diagnostic and Statistical Manual of Mental Disorders) is a particular Diagnostic Criteria for diagnosing mental disorders.
DSM 5 is a Problem Descriptor - no code

ICD-10 (International Classification of Diseases) is the "international standard for defining and reporting diseases and health conditions. It allows the world to compare and share health information using a common language. It defines the universe of diseases, disorders, injuries and other related health conditions."
ICD-10 is a Problem Descriptor AND Code

When a Counselor or Therapist goes to school and learns how to diagnose their patients, they are taught to use the DSM 5 (this particular Diagnostic Criteria).
When a Counselor or Therapist goes to work and has to diagnose an actual patient, they must use the DSM 5 AND the ICD-10.
The DSM 5 is what the Counselor or Therapist uses to identify the definition of the patient's problem. They then have to map and document the ICD-10 Diagnosis Code and Description in order to send that information to the payer to get paid.

Now, you can't have one without the other. ICD-10 is required for everyone covered by the Health Insurance Portability Accountability Act (HIPAA).

Imagine you went to school to learn to speak and write in French. You studied for a specific test on French and you passed! You learned all about how to write your documents in French and are now credentialed.

Now imagine you got a job! You now get to put your knowledge to practice and you start seeing patients. You see a patient and ask them a lot of questions and decide they have a certain diagnosis. Now you have to document all of the questions and answers so that when other people review your work, they can understand how you came to your conclusions about that diagnosis. You write it all in French. Unfortunately the people who pay you, only know German. You now have to also document the translation of the diagnosis in German. There is not always a direct one-to-one translation. You have to do your best to translate as closely as possible and defend the reasoning behind your translation.

To make matters worse, there are actually 2 types of ICD-10 Codes.

There is the ICD-10 as produced internationally by WHO (World Health Organization). The World Health Assembly adopted ICD-10 in 1990. They started the ICD-11 Beta Phase on May 14, 2012 and the final ICD-11 revision is due by 2018. This international version of ICD-10 is referred to sometimes as the Blue Book or the Green Book. Again, these are International versions of the ICD-10 codes.

Why reference the Blue Book or the Green Book at all?
The Blue Book and the Green Book include Diagnostic Criteria. They include information on underlying issues or symptoms that can be used to map them to a particular problem or Diagnosis.

The US ICD-10-CM (Clinical Modification), sometimes referred to as the "ICD-10 Tabular Index" is the list of Codes and Descriptions for diagnosis coding for use in all U.S. health care settings. There are differences between the ICD-10 and the ICD-10-CM. You may find a code in one and note the other.

Procentive has the ICD-10-CM (or ICD-10 Tabular Index) loaded into the Diagnosis Module for our customers. These are the ONLY diagnosis codes available for use in all U.S. health care settings.

So why have the DSM 5? According to the APA, "DSM-5 and the ICD should be thought of as companion publications. DSM-5 contains the most up-to-date criteria for diagnosing mental disorders, along with extensive descriptive text, providing a common language for clinicians to communicate about their patients. The ICD contains the code numbers used in DSM-5 and all of medicine, needed for insurance reimbursement and for monitoring of morbidity and mortality statistics by national and international health agencies. The APA works closely with staff from the WHO, CMS, and CDC-NCHS to ensure that the two systems are maximally compatible."

So to conclude, Counselors and Therapists should diagnosis in DSM 5 then use the Blue Book or Green Book (international versions of ICD-10) to diagnosis in ICD-10 and then double check the ICD-10-CM (ICD-10 Tabular Index) to make sure the code and diagnosis they have chosen is recognized in the US. They then need to document their findings and conclusions with the DSM 5 AND ICD-10.

Tips from CMS:
• While crosswalks from ICD-9 to ICD-10 can be useful references, ICD-10 codes should be based on the clinical documentation rather than selected from a crosswalk
• Practices that do not prepare for ICD-10 will not be able to submit claims for services performed on or after October 1, 2015

Information related to this can be found:
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Taking payments @ reception

Kim Ross 8 years ago in Appointments Module • updated 8 years ago • 3

Is anyone using the appointments module feature in the "change appointments" box that records at payment at checkin? There are two options: one for reference only and the other is a link that actually creates the payment. How is this working for you? Is there a report that can be used to access the "reference only" information? Also, the receipt prints as a full-size paper. Is there a way to reduce the size and paper waste?

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Chemical Health Billing

mboron 8 years ago in Billing/Electronic Modules • updated by mxiong 8 years ago • 1

When sending claims for Chemical Health Services to MN DHS for a Temp ADC (not an LADC yet), are we required to add a modifier for to show she is under Supervision? Such as and HN Modifier?

Thanks!

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Has anyone in the chemical dependency/substance abuse field had issues with the dx code Z13.89 not being paid by insurance companies?

mooremisc 8 years ago in ICD-10/DSM5 • updated 8 years ago • 8

I have tried to bill Blue Cross Blue Shield, Sanford Health, and UBH/Medica using the dx Z13.89 and the claims are being rejecting, saying the dx is too vague.

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Pro-trivia Time! How well do you know Procentive?

Sara Serier 8 years ago in Procentive News • updated by Kim Ross 8 years ago • 5

What other companies fall under the “Procentive” umbrella? (Bonus points if you can explain what they do!)

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Company Newsletters & Stories

Sara Serier 8 years ago in Industry News/Discussion • updated 8 years ago • 2

Do you send out company newsletters or updates?


We (Procentive) would love to know what is happening at your company, please add Procentive (or myself) to your mailing/electronic list!


Feel free to share your stories with all of us on the User Community as well!

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Looking for Resources

Sara Serier 8 years ago in Billing/Electronic Modules • 0

When you have troubles with claims or trying to figure out how to bill certain services, what are your favorite resources to find answers?

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How are you promoting the Client Portal to Patients?

Alan Olson 9 years ago in Client Portal • updated by jmorales 8 years ago • 2
Configuring the Client Portal is one thing. Getting clients excited to use it can be another challenge. How are other agencies promoting and encouraging clients to utilize this function? Handouts, flyers, therapist pitch?
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EHR Software

Sara Serier 8 years ago in Industry News/Discussion • 0

4,400 lives were saved in 2015 thanks to EHR software. We are so thankful to serve the mental health community and care for you as you care for others!


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From articles: 15 Ways Software Gave Back to the World in 2015

http://www.capterra.com/infographics/15-ways-software-gave-back-2015



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