By Alan Graham, PhD, PCC, MCAC, Guest Contributor.
Beginning October 1, 2015, all health care providers in the U.S. must convert to using a new diagnostic code set called ICD-10-CM. This includes psychologists, psychiatrists, and other mental health professionals too.
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
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, health insurance providers will likely reject claims and not pay for visits and/or prescribed medications. If a client comes to you panicked because their insurance has suddenly refused to pay, you can now explain that this is likely a coding issue between the provider and the insurance company. Encourage them to talk to and 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.
Alan R. Graham, PhD, PCC, MCAC is the Dean of ADD Coach Training for Mentorcoach. He serves on the Editorial Board of The Journal of Attention Disorders and is on the board of the Professional Association of ADHD Coaches (PAAC). Alan coaches executives with business and organizational challenges and adults, teens, children and parents impacted by ADHD. With Dr. Bill Benninger, Alan created ADDvisor.com, a website for sharing practical information about ADHD through email newsletters and teleconference workshops. You can reach him at Alan@ADDvisor.com.