Updated Behavioral Health ICD-10 Codes

The article below was written by Seth Krieger, SOS President, and shared with SOS users through the SOS Newsgroup and SOS User Group.

There are a handful of current ICD-10 psych-related diagnosis codes that will change on October 1 (the start of CMS’s 2017 Fiscal Year). Specifically:


See this link or type http://surl.sosoft.com/icd102016 into your web browser to view, download, or print a detailed reference sheet from American Psychiatric Association. Or try this link from the American Psychological Association which lists these eight codes which will be come fourteen codes beginning October 1.

You can also view a broader rundown of the upcoming changes on the CMS web site.

You will want to complete all your September claims prior to making any changes! Once your billing for all services through September 30 has been done, then make the needed Dx changes in Lookups > Diagnosis Codes and in affected patient claim setups (professional and institutional), plus in your Case Manager data, if you use SOS’s clinical records product.

Sound like a bunch of work? Well, we have you covered. SOS has created a new report that will sift through the places where you might have used one of these Dx codes, looking for the specific codes that are in the list of October 1, 2016 changes for mental/behavioral disorders. The report output looks like this:

The data in the sample above contains randomly generated values and no actual protected health information.

The highlighted rows belong to patients who have one or more Dx’s in the group above. Yellow signifies Professional (1500) claim setup; green indicates Institutional (UB04) claim setup; and cyan indicates Case Manager (clinical record) data. The report provides a way for you to quickly identify where you will have to make changes to avoid claim rejections and to stay current with the 10/2016 changes.

Rather than changing current claim setups, OM Pro users should create a new claim setup for Professional and/or Institutional claims, replacing the diagnosis codes that have changed. Don’t forget to mark the new claim setups as the Default before starting to enter new services in October!

IMPORTANT: This report includes the entire Active Patient List and could contain sensitive data. If your organization uses SOS’s Advanced Security to restrict staff access to patients, SOS recommends that you use the Admin Module security settings to limit usage of the report to just members of your “Supervisor” access group. If you need assistance with this task, please contact Support. An alternative would be to install the report, run it, then delete it.

This new report for SOS users can be downloaded at the following address: https://sosoft.com/files/downloads/ICD10-2016.rpt. Please note that clicking the link will download the report, not bring you to a page. If this does not work for you, please cut and paste the link into your browser URL bar.

Once downloaded, copy the report file into the SOS folder of only those computers that will be used to generate the report. Next, a Supervisor User should add an entry to one of your Report menus. Just open the desired menu, press the <Insert> key (or right-click, then select “Add”). Complete the form as shown below and save.

If you have any questions, let us know.

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