Mirean Coleman, LICSW, CT
Each year the National Center for Health Statistics, releases new, updated, or deleted codes for the International Classification of Diseases, Tenth Edition, Clinical Modification (ICD-10-CM). Clinical social workers should use the new codes to avoid reimbursement denials.
Mirean Coleman, MSW, LICSW, CT
Clinical social workers are one of many health care professionals who will be required to use the ICD-10-CM coding system when identifying mental health disorders.
Psychiatric diagnostic codes used by clinical social workers are found in the International Classification of Diseases, 10th Edition, Clinical Modification (ICD-10-CM) “F” section, F01-F99, on Mental and Behavioral Health Disorders. Third-party payers may individually decide which diagnostic codes they will reimburse clinical social workers for.
When seeking reimbursement from third-party payers, clinical social workers are required to use place of service codes in order to submit a professional claim form such as the CMS-1500. These codes specify where services are rendered and may result in a denied claim when used inappropriately.
Clinical social workers who seek independent reimbursement use Current Procedural Terminology (CPT) codes to identify procedures they perform when providing psychotherapy services. The Health Insurance Portability and Accountability Act (HIPAA) has designated CPT as the national coding standard for reporting procedures for health care professionals such as clinical social workers.
The International Classification of Diseases, 10th Edition, Clinical Modification, known as the ICD-10-CM, will be implemented on October 1, 2015. Clinical social workers are one of many health care professionals who will be required to use the ICD-10-CM coding system when identifying mental health disorders. The ICD 9-CM coding system will not be available for use for services provided on and after October 1, 2015.