Source: http://www.who.int/classifications/icd/en/ https://www.citelighter.com/science/psychology/knowledgecards/dsm-v
This unit will cover diagnosis coding for billing purposes. If you want to be paid by an insurance company or an EAP, you must utilize the correct codes for the session, as well as billable diagnosis. So let's dig in and figure it all out through the following two sections, diagnosis coding, CPT coding.
The ICD or International Classification of Diseases is the coding source book, not the DSM. The DSM is a good place to start in order to determine a diagnosis, but you'll need to utilize the ICD in order to find the correct or specific codes for specific diagnoses. The ICD includes many additional codes that the DSM does not and is also updated more often. You can Google search to find ICD codes related to a diagnosis.
A client can be given more than one ICD code based on the presenting problems, and you can change the ICD codes as treatment progresses or as presenting problems change. Note that a diagnosis code is a prerequisite for insurance reimbursement. You'll need to confirm that the diagnosis code is a covered benefit as well. Some diagnosis codes will be billable to one insurance and rejected by another. You may want to call the insurance company to confirm payment of the diagnosis.
CPT stands for Current Procedural Terminology. CPT codes are the numbers used by insurance companies and others to identify type of service, be it individual, group, or family counseling and the amount of time. When building an insurance company, a CPT code is required for all services provided and must be on every claim.
Although there are many different CPT codes in mental health, it is likely that you'll use probably less than 25 of the codes. The most common CPT codes used in mental health include 90791. This indicates an initial session with an individual. 90834, this indicates 45-minute sessions with an individual. 90837, these are 60-minute sessions with an individual.
Google search CPT codes and mental health to see other billable codes. Important note here, when an insurance company executes a contract, the list of billable CPT codes and amount paid for each code is included in that contract. These amounts may be negotiable and one of the only ways a counselor will get more money is to ask.
Here's what we covered in this lesson, diagnosis coding, CPT coding.
(00:00-00:27) Introduction
(00:28-01:34) Diagnosis Coding
(01:35-02:55) CPT Coding
(02:56-03:06) Summary