ICD vs DSM

Questions are still coming in re: what to do about DSM 5.

The answer is still the same-you may do nothing if you please. There is NO federal law requiring its use. When you bill for a session and use a DSM 4 code it is translated into an ICD 9 code by every insurance company.  Therefore you may still use the DSM 4 code which is really the ICD 9 code

All that changes on Oct. 1st 2014 at which time HIPAA will require all health care to document using ICD 10. This large book covers all medical fields. Mental health is in section 5 and can be down loaded for free. You will not find detailed clinical guidance as to how to define each diagnosis.

So you can use DSM 5 if you wish. You can still use DSM 4 if you wish but only till Oct. 1, 2014. All billing is currently ICD and will remain ICD.

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convention

What a wonderful gathering of the clan. Hundreds of NYSPA members coming together for education and good cheer.

I found the keynote by Allen Frances,MD to be one of the highlights.His review of the history of DSM as well as the problems with the latest volume was a perfect match to Jerome Wakefield’s review of the content of DSM 5. Wakefield’s  presentation was highly useful and of high caliber.

On a personal note, my receiving the Allen V. Williams Memorial award was such a thrill. I thank council for this honor. I have it on my wall, in my office, and it brings me much pride.

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DSM 5

DSM 5 will be out in a week or so. Do we need to use it???

We never needed to use DSM 4. DSM is for a description of diagnostic criteria only. If you want to get paid you use ICD 9. DSM and ICD are so similar in the Dx code that every billing company crosswalked DSM to ICD. You have been  using ICD for years.

So you dont have to buy DSM5 unless you want to.ICD 9 is free and on line. ICD 10 is mandated on 10/1/14. It too is already on line and free. expect a cross walk for both.

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Mental Health and Stigma

I once had neighbors who were fascinated by my being a psychologist.Question after question would be asked about my field.I later learned that they were in couples therapy but didn’t want anyone to know.So why the secret? Why stigma?

People want to separate themselves from those who “need therapy”. But why? And how can we get to talk about “we” and not “them?

Research published in the Journal of Health and Social Behavior[Vol 41. No 2] finds that 68% of Americans do not want someone with a mental illness marrying into their family and 58% do not want people with mental illness in their workplace.

We have work to do.

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Regional Differences

When I post information on my blog or in the Dispatch I will often get a response from a member saying that my information does not seem to apply to them so I must be wrong. What they may not realize is the size of our state and the differences from region to region.

The downstate folks are rightly upset by the UBH fee reduction but they may not know that our colleagues in Syracuse and Rochester are facing an 11% reduction from BCBS Excellus.

NYC folks may not take managed medicaid due to the low fees while many in upstate get the same rate for commercial coverage and managed medicaid from most companies.

In other words, there are location differences, often based upon the number of providers in the area, which impacts contracts.

 

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Further updates on Exemptions

As the legislators rush to finish the budget we are getting info on the state of current negotiations.

Seems that they are kicking the can down the road. No fix in sight. 3 year extension. what will happen during this time is count and reporting on all things about staffing and licensing. SED will get the reports and make recommendations to the legislature. That is the latest.

 

 

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Exemption Update

As you may recall the state agencies which were granted exemptions a decade ago were told to hire licensed psychologists so they would be in compliance by this year. This year the exemptions were to end. Except that Governor Cuomo made the exemptions permanent in his budget. 

Now the Senate and Assembly have proposed a 3 year extension of the exemption. This has to be negotiated with the Governor and resolved in about a week. So there you have it. Lets see what next week brings.

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