Each month, IBC will feature an example of how ICD-9 codes will translate to
ICD-10 codes. We will present coding examples from different specialties and
popular disease categories to demonstrate the granularity that the new ICD-10
code set will provide.
CODING CONVENTION/GUIDELINE: MENTAL AND BEHAVIORAL
DISORDERS
As in ICD-9, the codes for mental and behavioral disorders are located in
Chapter 5 of ICD-10. However, in ICD-10, the clinical terminology and
classification of many conditions are different. There are also more
subchapters, categories, subcategories, and codes that provide greater clinical
detail. This includes some changes in names and definitions of disorders to
reflect more current clinical terminology and standardization of the terms used
to diagnosis mental, behavioral, and substance use disorders.
One difference involves the classification of substance use, abuse, and
dependence. In ICD-10, the terms are not interchangeable as they are in ICD-9;
they are separate conditions in ICD-10.
Condition: Alcohol-induced psychotic disorder with delusions
Substance
ICD-9
ICD-10
Use
291.5 Alcohol-induced psychotic disorder with delusions
F10.950 Alcohol use, unspecified with alcohol-induced psychotic disorder with
delusions
Abuse
291.5 Alcohol-induced psychotic disorder with delusions
F10.150 Alcohol abuse with alcohol-induced psychotic disorder with delusions
Dependence
291.5 Alcohol-induced psychotic disorder with delusions
F10.250 Alcohol dependence with alcohol-induced psychotic disorder with
delusions
Alcohol dependence, drug dependence, and non-dependent abuse of drugs are
classified into three different categories. The ICD-10 codes identify the
aspects of use (e.g., withdrawal state), the effects (e.g., dependence), and
the manifestations (e.g., with delirium).
Condition: Opioid use, abuse, and dependence
Categories
ICD-10
Aspects of use
F11.23 Opioid dependence with withdrawal
Effects
F11.10 Opioid abuse, uncomplicated
F11.20 Opioid dependence, uncomplicated
Manifestations
F11.151 Opioid abuse with opioid-induced psychotic disorder with hallucinations
F11.282 Opioid dependence with opioid-induced sleep disorder
F11.921 Opioid use, unspecified with intoxication delirium
In addition to the clinical terminology and classification changes, unlike
ICD-9, there are chapter-specific guidelines for mental and behavioral
disorders in ICD-10. These consist of pain disorders related to psychological
factors and disorders due to psychoactive substance use (i.e., in remission,
psychoactive substance use, abuse, and dependence).
Pain disorders related to psychological factors
There is a distinctive code assignment when the pain is exclusively related or
indirectly related to psychological factors.
ICD-10
F45.41 Pain disorder exclusively related to psychological factors
F45.42 Pain disorder with related psychological factors
Mental and behavioral disorders due to psychoactive substance use
In remission: The appropriate code assignments for ?in remission? are assigned
only on the basis of provider documentation.
Psychoactive substance use, abuse, and dependence: When the provider
documentation refers to use, abuse, and dependence of the same substance (e.g.,
alcohol, opioid, cannabis, etc.), only one code should be assigned to identify
the pattern of use based on the following hierarchy:
If both use and abuse are documented, assign only the code for abuse.
If both abuse and dependence are documented, assign only the code for
dependence.
If use, abuse, and dependence are all documented, assign only the code for
dependence.
If both use and dependence are documented, assign only the code for dependence.
For additional information related to the IBC transition to ICD-10, please
visit the ICD-10 section of our website.
On this site you will also find other examples of how ICD-9 codes will
translate to ICD-10 codes in the ICD-10 Spotlight: Know the codes booklet.