![]() The following chart shows the current, full DSM-5 diagnosis list. (The DSM-5, in contrast, only lists 297 disorders.) Z codes and V codes designate “other conditions that may be a focus of clinical attention”, but they are not considered disorders. To make matters even more complicated, the US uses its own variant of the ICD-10 called the Clinical Modification (ICD-10-CM), which has almost 70,000 diagnosis codes. These recommended, HIPAA-compliant codes were just updated in October 2021. The ICD is currently in its 11th iteration (ICD-11), but the US will continue to use ICD-9 and ICD-10 codes for billing and classification purposes until it fully implements ICD-11 in ~2027. Rather, the manual uses coding protocols from the International Classification of Diseases (ICD), which was developed by the World Health Organization (WHO). The DSM-5 does not apply its own classification codes for each individual mental health disorder. The current version of this diagnostic manual is the Fifth Edition, or the DSM-5 (2013). In the US, mental health professionals primarily use the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association (APA), as an authoritative clinical guide to diagnosing and treating mental health and behavioral conditions. Disorders that people live with throughout the lifespan are called chronic mental illnesses. Some psychiatric conditions may be temporary, occur occasionally, and never return again. Mental disorders are connected with distress and/or impairment in functioning, whether that be socially, occupationally, or in some other dimension of life.Īccording to the National Institute of Mental Health (NIMH), about one in five adults lives with a mental disorder (any mental illness, or AMI) in the US, and about one in 18 American adults has a serious mental illness (SMI). Therefore, these diagnosis codes are added to the excluded lists and will not be found on the valid lists for NGHP plan types.Mental disorders (aka mental illnesses) are health conditions that involve changes in thinking, emotion, or behavior-or some combination of the three. ![]() ![]() Additionally, CMS has also determined that certain valid diagnosis codes do not provide enough information related to the cause and nature of an illness, incident, or injury to be complete, useful, or adequate for Section 111 Claim Input File submissions. However, a “V” code may be used in certain circumstances, such as to identify the Alleged Cause of Injury, Incident, or Illness, which is the reason why “V” codes will not appear on the list of excluded ICD-10 codes. These “Z” codes, therefore, are also excluded from Section 111 claim reports. ICD-9 “V” codes are equivalent to ICD-10 “Z” codes (e.g., factors influencing health status and contact with health services). For example, ICD-9 codes beginning with the letter “V” and ICD-10 codes beginning with the letter “Z” are removed from the valid lists. Not all code types are added to the valid lists. New valid codes are added and descriptions of existing codes are revised annually. Once identified for Section 111 reporting, diagnosis codes are retained on the lists from year to year. CMS reviews ICD 10 codes annually to identify the codes that may be used for Section 111 NGHP Claim Input File Detail Record submissions. There are diagnosis codes that are applicable to liability and workers’ compensation situations but are not applicable to no-fault accidents or injuries. The diagnosis code lists are derived from ICD-10 diagnosis codes that CMS posts each year so that providers and suppliers utilize the applicable diagnosis codes when submitting medical claims to Medicare. Excluded Liability and No-Fault ICD-9 List.Excluded Liability and No-Fault ICD-10 List.The valid lists also include the No-Fault Plan Type D exclusion indicators. ICD-9 and ICD-10 Codes for Section 111 ReportingĬlick the links below to download the 2024 valid and excluded ICD diagnosis code lists in Excel (.xlsx). ![]() The ICD-9 and ICD-10 valid and excluded diagnosis codes for the latest fiscal year are made available to non-group health plan (NGHP) responsible reporting entities (RREs) and agents for Section 111 liability insurance (including self-insurance), no-fault, and workers’ compensation mandatory reporting.
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