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The DSM-5 (2013), the current version, also features ICD-9-CM codes, listing them alongside the codes of Chapter V of the ICD-10-CM. On 1 October 2015, the United States health care system officially switched from the ICD-9-CM to the ICD-10-CM. [1] [2] The DSM is the authoritative reference work in diagnosing mental disorders in the world.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) instructed CMS to adopt a standard coding systems for reporting medical transactions. The use of Level III codes was discontinued on December 31, 2003, in order to adhere to consistent coding standards.
The CPT code revisions in 2013 were part of a periodic five-year review of codes. Some psychotherapy codes changed numbers, for example 90806 changed to 90834 for individual psychotherapy of a similar duration. Add-on codes were created for the complexity of communication about procedures.
V76 Special screening for malignant neoplasms; V77 Special screening for endocrine nutritional metabolic and immunity disorders; V78 Special screening for disorders of blood and blood-forming organs; V79 Special screening for mental disorders and developmental handicaps; V80 Special screening for neurological eye and ear diseases
Reimbursement for early detection has been notoriously poor. However, in 2005 the Centers for Medicare and Medicaid Services enabled providers to add the -25 modifier to their preventive service code and to bill separately from the well-visit for 96110 (the developmental-behavioral screening code). Nationally, reimbursement now averages about $10.
The expansion of healthcare delivery systems and changes in global health trends prompted a need for codes with improved clinical accuracy and specificity. [49] The alphanumeric coding in ICD-10 is an improvement from ICD-9 which had a limited number of codes and a restrictive structure. [49]
The current version, ICD-10, will transition to ICD-11 in 2025, requiring updated coding practices. [14] CPT Codes: Created by the American Medical Association (AMA), Current Procedural Terminology (CPT) codes correspond to the procedures or treatments performed by the healthcare provider.
The original mammogram codes (film based mammograms) are CPT codes (77055, 77056, and 77057), so it would be easy to overlook the increasingly used digital mammogram codes that remain as HCPCS Level 2 codes if one did not know they existed (and possibly under-report mammogram statistics).