Provider Bulletin Philadelphia Department of Behavioral Health Community Behavioral Health State Allowable ICD-9-CM Codes.

Transcription

1 Provider Bulletin Philadelphia Department of Behavioral Health Community Behavioral Health State Allowable ICD-9-CM Codes. February 12, 2007 The Commonwealth of Pennsylvania lists the allowable ICD-9-CM (International Classification of Disease 9 th Revision, Clinical Modification) diagnosis codes in the Behavioral Health Services Reporting Classification Chart (BHSRCC). The BHSRCC is published and provided to CBH twice a year. The chart listed below contains the only allowable diagnosis codes as of January 1, This chart will be enforced via the CBH claims system as of March 15, The chart is currently available on the CBH website All future modifications to this chart will be published on the CBH website and providers will have the responsibility to check the website for any changes. At the current time the Commonwealth updates the BHSRCC in January and July. When using a diagnosis code please make sure that the number of digits after decimal point is correct and correspond to the one of the codes on the chart below. For example, when the diagnosis is Senile dementia, uncomplicated please ensure that the code is used, not 290 or Likewise, if a diagnosis code requires two digits after the decimal point both digits must be present. For instance, diagnosis Presenile dementia, uncomplicated must be coded as , not as Dementias List of ICD-9-CM codes appropriate for billing (Behavioral Health Services Classification Chart, January 2007) Senile dementia, uncomplicated Presenile dementia Presenile dementia, uncomplicated Presenile dementia with delirium Presenile dementia with delusional features Presenile dementia with depressive features Senile dementia with delusional or depressive features Senile dementia with delusional features Senile dementia with depressive features Senile dementia with delirium Vascular dementia Vascular dementia, uncomplicated Vascular dementia with delirium Vascular dementia with delusions Vascular dementia with depressed mood *Code was added beginning 01/01/ of 14

2 290.8 Other specified senile psychotic conditions Unspecified senile psychotic condition Alcohol-induced mental disorders Alcohol withdrawal delirium Alcohol-induced persisting amnestic syndrome Alcohol-induced persisting dementia Alcohol-induced psychotic disorder with hallucinations Idiosyncratic alcohol intoxication Alcohol-induced psychotic disorder with delusions Other specified alcoholic psychosis Alcohol withdrawal * Alcohol induced sleep disorders Other Unspecified alcohol-induced mental disorder Drug-induced mental disorder Drug withdrawal Drug-induced psychotic disorders Drug-induced psychotic disorder with delusions Drug-induced psychotic disorder with delusions hallucinations Pathological drug intoxication Other specified drug-induced mental disorders Drug-induced delirium Drug-induced persisting dementia Drug-induced persisting amnestic disorder Drug-induced mood disorder * Drug-induced sleep disorders Other Unspecified drug-induced mental disorder Transient mental disorders due to conditions classified elsewhere Delirium due to conditions classified elsewhere Subacute delirium Other specified transient mental disorders due to conditions classified elsewhere Psychotic disorder with delusions in conditions classified elsewhere Psychotic disorder with hallucinations in conditions classified elsewhere Mood disorder in conditions classified elsewhere Anxiety disorder in conditions classified elsewhere Other Unspecified transient mental disorder in conditions classified elsewhere Persistent mental disorders due to conditions classified elsewhere Amnestic disorder in conditions classified elsewhere *Code was added beginning 01/01/ of 14

3 Dementia in conditions classified elsewhere Dementia in conditions classified elsewhere without behavioral disturbance Dementia in conditions classified elsewhere with behavioral disturbance Other persistent mental disorders due to conditions classified elsewhere Unspecified persistent mental disorders due to conditions classified elsewhere Schizophrenic disorders Simple type Unspecified Subchronic Chronic Subchronic with acute exacerbation Chronic with acute exacerbation In remission Disorganized type Unspecified Subchronic Chronic Subchronic with acute exacerbation Chronic with acute exacerbation In remission Catatonic type Unspecified Subchronic Chronic Subchronic with acute exacerbation Chronic with acute exacerbation In remission Paranoid type Unspecified Subchronic Chronic Subchronic with acute exacerbation Chronic with acute exacerbation In remission Schizophreniform disorder Unspecified Subchronic Chronic Subchronic with acute exacerbation Chronic with acute exacerbation In remission Latent schizophrenia Unspecified Subchronic Chronic Subchronic with acute exacerbation *Code was added beginning 01/01/ of 14

4 Chronic with acute exacerbation In remission Residual type Unspecified Subchronic Chronic Subchronic with acute exacerbation Chronic with acute exacerbation In remission Schizoaffective disorder Unspecified Subchronic Chronic Subchronic with acute exacerbation Chronic with acute exacerbation In remission Other specified types of schizophrenia Unspecified Subchronic Chronic Subchronic with acute exacerbation Chronic with acute exacerbation In remission Unspecified schizophrenia Unspecified Subchronic Chronic Subchronic with acute exacerbation Chronic with acute exacerbation In remission Episodic mood disorders Bipolar I disorder, single manic episode Unspecified Mild Moderate Severe, without mention of psychotic behavior Severe, specified as with psychotic behavior In partial or unspecified remission In full remission Manic disorder, recurrent episode Unspecified Mild Moderate Severe, without mention of psychotic behavior Severe, specified as with psychotic behavior In partial or unspecified remission In full remission *Code was added beginning 01/01/ of 14

5 Major depressive disorder, single episode Unspecified Mild Moderate Severe, without mention of psychotic behavior Severe, specified as with psychotic behavior In partial or unspecified remission In full remission Major depressive disorder, recurrent episode Unspecified Mild Moderate Severe, without mention of psychotic behavior Severe, specified as with psychotic behavior In partial or unspecified remission In full remission Bipolar I disorder, most recent episode (or current) manic Unspecified Mild Moderate Severe, without mention of psychotic behavior Severe, specified as with psychotic behavior In partial or unspecified remission In full remission Bipolar I disorder, most recent episode (or current) depressed Unspecified Mild Moderate Severe, without mention of psychotic behavior Severe, specified as with psychotic behavior In partial or unspecified remission In full remission Bipolar I disorder, most recent episode (or current) mixed Unspecified Mild Moderate Severe, without mention of psychotic behavior Severe, specified as with psychotic behavior In partial or unspecified remission In full remission Bipolar I disorder, most recent episode (or current) unspecified Other and unspecified bipolar disorders Bipolar disorder, unspecified Atypical manic disorder Atypical depressive disorder Other *Code was added beginning 01/01/ of 14

6 Other and unspecified episodic mood disorder Unspecified episodic mood disorder Other specified episodic mood disorder Delusional disorders Paranoid state, simple Delusional disorder Paraphrenia Shared psychotic disorder Other specified paranoid states Unspecified paranoid state Other nonorganic psychoses Depressive type psychosis Excitative type psychosis Reactive confusion Acute paranoid reaction Psychogenic paranoid psychosis Other and unspecified reactive psychosis Unspecified psychosis Pervasive developmental disorders Autistic disorder Current or active state Residual state Childhood disintegrative disorder Current or active state Residual state Other specified pervasive developmental disorders Current or active state Residual state Unspecified pervasive developmental disorders Current or active state Residual state Anxiety, dissociative and somatoform disorders Anxiety states Anxiety state, unspecified Panic disorder without agoraphobia Generalized anxiety disorder Other Dissociative, conversion and factitious disorders Hysteria, unspecified Conversion disorder Dissociative amnesia Dissociative fugue Dissociative identity disorder Dissociative disorder or reaction, unspecified Factitious disorder with predominantly psychological signs and symptoms *Code was added beginning 01/01/ of 14

7 Other and unspecified factitious illness Phobic disorders Phobia, unspecified Agoraphobia with panic disorder Agoraphobia without mention of panic attacks Social phobia Other isolated or simple phobias Obsessive-compulsive disorders Dysthymic disorder Neurasthenia Depersonalization disorder Hypochondriasis Somatoform disorders Somatization disorder Undifferentiated somatoform disorder Other somatoform disorders Unspecified nonpsychotic mental disorder Personality disorders Paranoid personality disorder Affective personality disorder Affective personality disorder, unspecified Chronic hypomanic personality disorder Chronic depressive personality disorder Cyclothymic disorder Schizoid personality disorder Schizoid personality disorder, unspecified Introverted personality Schizotypal personality disorder Explosive personality disorder Obsessive-compulsive personality disorder Histrionic personality disorder Histrionic personality disorder, unspecified Chronic factitious illness with physical symptoms Other histrionic personality disorder Dependent personality disorder Antisocial personality disorder Other personality disorders Narcissistic personality disorder Avoidant personality disorder Borderline personality disorder Passive-aggressive personality Other *Code was added beginning 01/01/ of 14

8 301.9 Unspecified personality disorder Sexual and gender identity disorders Ego-dystonic sexual orientation Zoophilia Pedophilia Transvestic fetishism Exhibitionism Trans-sexualism With unspecified sexual history With asexual history With homosexual history With heterosexual history Gender identity disorder in children Psychosexual dysfunction Psychosexual dysfunction, unspecified Hypoative sexual desire disorder With inhibited sexual excitement Female orgasmic disorder Male orgasmic disorder Premature ejaculation Dyspareunia, psychogenic With other specified psychosexual dysfunctions Other specified psychosexual disorders Fetishism Voyeurism Sexual masochism Sexual sadism Gender identity disorder in adolescents or adult Other Unspecified psychosexual disorder Alcohol dependence syndrome Acute alcoholic intoxication Unspecified Continuous Episodic In remission Other and unspecified alcohol dependence Unspecified Continuous Episodic In remission Drug dependence Opioid type dependence *Code was added beginning 01/01/ of 14

9 Unspecified Continuous Episodic In remission Sedative, hypnotic or anxiolytic dependence Unspecified Continuous Episodic In remission Cocaine dependence Unspecified Continuous Episodic In remission Cannabis dependence Unspecified Continuous Episodic In remission Amphetamine and other psychostimulant dependence Unspecified Continuous Episodic In remission Hallucinogen dependence Unspecified Continuous Episodic In remission Other specified drug dependence Unspecified Continuous Episodic In remission Combinations of opioid type drug with any other Unspecified Continuous Episodic In remission Combinations of drug dependence excluding opioid type drug Unspecified Continuous Episodic In remission Unspecified drug dependence Unspecified Continuous *Code was added beginning 01/01/ of 14

10 Episodic In remission Nondependent abuse of drugs Alcohol abuse Unspecified Continuous Episodic In remission Tobacco use disorder Cannabis abuse Unspecified Continuous Episodic In remission Hallucinogen abuse Unspecified Continuous Episodic In remission Sedative, hypnotic or anxiolytic abuse Unspecified Continuous Episodic In remission Opioid abuse Unspecified Continuous Episodic In remission Cocaine abuse Unspecified Continuous Episodic In remission Amphetamine or related acting sympathomimetic abuse Unspecified Continuous Episodic In remission Antidepressant type abuse Unspecified Continuous Episodic In remission Other, mixed, or unspecified drug abuse Unspecified Continuous *Code was added beginning 01/01/ of 14

11 Episodic In remission Physiological malfunction arising from mental factors Musculoskeletal Respiratory Cardiovascular Skin Gastrointestinal Genitourinary Psychogenic genitourinary malfunction, unspecified Psychogenic vaginismus Psychogenic dysmenorrhea Psychogenic dysuria Other Endocrine Organs of special sense Other specified psychophysiological malfunction Unspecified psychophysiological malfunction Special symptoms or syndromes, not elsewhere classified Stuttering Anorexia nervosa Tic disorder, unspecified Transient tic disorder Chronic motor or vocal tic disorder Tourette s disorder Stereotypic movement disorder Specific disorders of sleep of nonorganic origin Nonorganic sleep disorder, unspecified Transient disorder of initiating or maintaining sleep Persistent disorder of initiating or maintaining sleep Transient disorder of initiating or maintaining wakefulness Persistent disorder of initiating or maintaining wakefulness Circadian rhythm sleep disorder of nonorganic origin Sleep arousal disorder Other dysfunctions of sleep stages or arousal from sleep Repetitive intrusions of sleep Other Other and unspecified disorders of eating Eating disorder, unspecified Bulimia nervosa Pica Rumination disorder Psychogenic vomiting *Code was added beginning 01/01/ of 14

12 Other Enuresis Encopresis Pain disorders related to psychological factors Psychogenic pain, site unspecified Tension headache Other Other and unspecified special symptoms or syndrome Acute reaction to stress Predominant disturbance of emotions Predominant disturbance of consciousness Predominant psychomotor disturbance Other acute reactions to stress Mixed disorders as reaction to stress Unspecified acute reaction to stress Adjustment reaction Adjustment disorder with depressed mood Prolonged depressive reaction With predominant disturbance of other emotions Separation anxiety disorder Emancipation disorder of adolescence and early adult life Specific academic or work inhibition Adjustment disorder with anxiety Adjustment disorder with mixed anxiety and depressed mood Other Adjustment disorder with disturbance of conduct Adjustment disorder with mixed disturbance of emotions and conduct Other specified adjustment reactions Posttraumatic stress disorder Adjustment reaction with physical symptoms Adjustment reaction with withdrawal Other Unspecified adjustment reaction Specific nonpsychotic mental disorders due to brain damage Frontal lobe syndrome Personality change due to conditions classified elsewhere Postconcussion syndrome Other specified nonpsychotic mental disorder following organic brain damage Unspecified nonpsychotic mental disorder following organic brain damage Depressive disorder, not elsewhere classified 311 Depressive disorder not elsewhere classified *Code was added beginning 01/01/ of 14

13 Disturbance of conduct, not elsewhere classified Undersocialized conduct disorder, aggressive type Unspecified Mild Moderate Severe Undersocialized conduct disorder, unaggressive type Unspecified Mild Moderate Severe Socialized conduct disorder Unspecified Mild Moderate Severe Disorders of impulse control, not elsewhere classic Impulse control disorder, unspecified Pathological gambling Kleptomania Pyromania Intermittent explosive disorder Isolated explosive disorder Other Mixed disturbance of conduct and emotions Other specified disturbances of conduct, not elsewhere Conduct disorder, childhood onset type Conduct disorder, adolescent onset type Other conduct disorder Unspecified disturbance of conduct Disturbance of emotions specific to childhood and adolescence Overanxious disorder Misery and unhappiness disorder Sensitivity, shyness, and social withdrawal disorder Shyness disorder of childhood Introverted disorder of childhood Selective mutism Relationship problems Other or mixed emotional disturbances of childhood Oppositional defiant disorder Identity disorder Academic underachievement disorder *Code was added beginning 01/01/ of 14

14 Other Unspecified emotional disturbance of childhood or Hyperkinetic syndrome of childhood Attention deficit disorder Without mention of hyperactivity With hyperactivity Hyperkinesis with developmental delay Hyperkinetic conduct disorder Other specified manifestations of hyperkinetic syndrome Unspecified hyperkinetic syndrome Specific delays in development Specific reading disorder Reading disorder, unspecified Alexia Developmental dyslexia Other Mathematics disorder Other specific learning difficulties Developmental speech or language disorder Expressive language disorder Mixed receptive-expressive language disorder Other Development coordination disorder Mixed development disorder Other specified delays in development Unspecified delay in development Psychic factors associated with diseases classified elsewhere 316 Psychic factor associated with diseases classified elsewhere Mild mental retardation 317 Mild mental retardation Other specified mental retardation Moderate mental retardation Severe mental retardation Profound mental retardation Unspecified mental retardation 319 Unspecified mental retardation Other unknown and unspecified cause Other unknown and unspecified cause *Code was added beginning 01/01/ of 14