Most professional psychologists are already using the World Health Organization’s International Classification of Diseases (ICD) without even
When a psychologist submits a diagnostic code drawn
from the Diagnostic and Statistical Manual (DSM) to an
insurer for reimbursement, that insurer receives the code as an
ICD code, says Lynn Bufka, PhD, assistant executive director
for practice research and policy in APA’s Practice Directorate.
That’s because the DSM-IV and the ICD-9-CM — the
version clinically modified by the Centers for Disease Control
and Prevention (CDC) for use in the United States — have
been “harmonized” and so are very similar.
All that will change starting Oct. 1, when the United States
will shift from the ICD-9-CM to the ICD-10-CM. The new
version differs considerably from the DSM, with new codes,
plus a new alphanumeric coding system to replace the old
Some insurers have already announced they will no longer
accept DSM codes for billing. And some say that could be a
problem for professional psychologists, who worry that both
psychologists already in practice and those still in training
aren’t prepared to make that transition.
The global standard
The ICD is the global clinical and research standard for both
physical and mental health conditions, says Princeton, N.J.,
private practitioner Carol D. Goodheart, EdD, author of the
forthcoming “A Primer for ICD-10-CM-Users: Psychological
and Behavioral Conditions.” The volume, which will be
available in January, is the first in a series of APA books and
resources designed to help psychologists make the transition
to the ICD-10-CM.
As a World Health Assembly member state, the United
States is required by treaty to use the ICD, Goodheart
explains. (Clinicians outside the United States have already
been using the ICD- 10 since soon after it was published in
1990 and are now preparing to transition to the ICD- 11,
expected in 2015.)
What’s more, the Health Insurance Portability and
Accountability Act (HIPAA) requires the use of ICD
diagnostic codes rather than DSM codes.
“All psychologists who offer health-care services, such
as psychotherapy or initial evaluations, and who expect
reimbursement from health insurers — or whose patients
expect reimbursement from insurers — must use ICD codes,”
says Goodheart, adding that psychologists shouldn’t confuse
the ICD’s diagnostic codes with the procedure codes known
as the Current Procedural Terminology, or CPT, codes.
Your diagnostic codes
As of Oct. 1, psychologists will need to use the latest version of the
International Classification of Diseases. Here’s how to get up to speed.
BY REBECCA A. CLAY