New Diagnostic Coding System May Impact Your Clients

Beginning October 1, 2015, all health care providers in the U. S. must convert to using a new diagnostic code set called ICD-10-M.  This includes psychologists, psychiatrists, and other mental health professionals, too.

This is important for ADHD coaches to be aware of because if health care providers do not enter the correct new diagnostic codes for ADHD, then clients’ health insurance providers will reject their claims and not pay for visits and/or prescribed medications.

The ICD is the global standard in diagnostic classification for health reporting and clinical applications for all medical diagnoses, including mental health and behavioral disorders.  It’s anticipated that use of this new diagnostic coding system will reduce the need to include supporting documentation with claims, result in more efficient claims management, require fewer requests for clinical information, and reduce the number of rejected claims due to non-specific diagnoses.  But while our entire medical community is getting familiar with these new codes, it’s going to be a serious headache for a while.

The new diagnostic codes for ADHD are:

Inattentive type = F90.0

Hyperactive-Impulsive type = F90.1

Combined type = F90.2

If a client comes to you panicked because their insurance has suddenly refused to pay, you can now explain that their doctor may just have made a mistake when using the new coding system.  Encourage them to work with their providers through this transition.  Ultimately, this should prove to be a good thing for all involved; it’s just going to take a while.