Coding Depression, Schizophrenia, and Bipolar Disorder

[Pages:2]The ICD-10 Informant

June 2021

Coding Depression, Schizophrenia, and Bipolar Disorder

Major depressive disorder, bipolar disorders, and other anxiety disorders are common types of affective disorders. Affective disorders are common mental diseases with symptoms ranging from mild to severe and life threatening.

Depression = categories F32 (major depressive disorder, single episode) and F33 (major depressive disorder, recurrent)

Categories F32 and F33 are further subdivided with 4th and sometimes 5th characters to designate

severity:

0

Mild

Mild: Few if any symptoms with intensity of symptoms is manageable and the symptoms result in minor social or occupational impairment.

1

Moderate

2

Severe, without psychotic features

3

Severe with psychotic features

4

In remission ? Category F33

4

Partial remission - Category F32

Moderate: Increased number & intensity of symptoms with functional impairment between those indicated for mild or severe episodes.

Severe: The number of symptoms is substantial. The intensity of symptoms is distressing & unmanageable. Symptoms markedly interfere with social and occupational functions.

5

In full remission (Only for category F32) Partial remission ? Symptoms of the immediately previous

8

Other

9

Unspecified

major depressive episode are present but full criteria are not met or there is a less than 2 month period w/o significant symptoms.

Full remission ? During the past 2 months, no significant signs or symptoms are present.

4th characters 1 - 8 are assigned only when provider documentation of severity is included in the medical record

Depression or major depression NOS = F32.9 ? which carries NO risk value

DSM-5 vs. ICD-10

DSM-5 provides the criteria and definitions to accurately determine a patient's diagnosis by thoroughly describing disorders.

ICD-10-CM provides a code number once the diagnosis has been established. Coding assignments for mental disorders are made according to ICD-10-CM. Mental health coders should understand DSM-5 but always use ICD-10-CM to make coding assignments.

Questions or comments?

Employed providers/staff contact OHSU Health HCC ? hccteam@ohsu.edu Community providers/staff contact Lynn Stachlowski ? stachlow@ohsu.edu

The ICD-10 Informant

June 2021

Coding Depression, Schizophrenia, and Bipolar Disorder

The Patient Health Questionnaire-9 (PHQ-9) is common screening tool given to patients in the primary care setting to screen for the presence and severity of depression. It includes 9 self-administered questions and a scoring rubric that helps providers easily understand the severity of a patient's depressive symptoms.

Coders cannot infer a diagnosis/severity based on PHQ-9 results but can query for clarification if part of your existing work and if documentation is conflicting or unclear.

Bipolar Disorder and Schizophrenia

These code sets (F31 and F20) require provider specification of the TYPE of disorder. Some common terms to look for:

Schizophrenia:

Paranoid Disorganized Catatonic Undifferentiated Residual Schizoaffective disorder

Bipolar:

Hypomanic Manic Depressed Mixed Bipolar II With psychotic features

JOIN US FOR MORE DURING THE WEBINAR ? JUNE 15TH, 2021 @ 8:00AM

SEND US YOUR QUESTIONS NOW AND WE WILL ANSWER THEM IN THE WEBINAR!

Questions or comments? Employed providers/staff contact OHSU Health HCC ? hccteam@ohsu.edu Community providers/staff contact Lynn Stachlowski ? stachlow@ohsu.edu

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download