Mental Health

Question 1

Neurocognitive disorders

Answer 1

Mandatory to use additional code for underlying disorder if documented
F00 -F09

Question 2

Alzheimer’s disease

Answer 2

Classified to:
G30.^+ ~ * Alzheimer’s disease*

F00.^ * ~ dementia and Alzheimer’s disease

• Senile /pre-senile dementia not classified to Alzheimer’s disease unless specified in documents
• Can be coded to early onset if documentation confirms it arose before 65 or if stated as early if patient is older than 65
• Note if documentation or doctor says early onsets if patient is older than 65, still code early onset

Question 3

Vascular cognitive disorders

Answer 3

Due to underlying cerebrovascular disease such as:
- arteriosclerotic dementia
- multi-infarct dementia

May say patient admitted for dementia due to cerebral arteriosclerosis

-F01.^

Question 4

Psychoactive substance use - mental and/ or behavioral disorder resulting from prescribed use

Answer 4

If:
When mental or behavioral disorder results from substance taken as prescribed.

Then:
Use external cause code to identify drug causing adverse effect ( code as adverse effect of)

F10-F19

Question 5

Acute intoxication versus psychosis

Answer 5

Watch include/ excludes and alphabetical index

** Psychotic disorder includes**
Psychotic phenomena that occurred during or following substance use

Acute use fourth character .0
Psychotic use fourth character.5

Question 6

Harmful use

Answer 6

Pattern of use that causes mental or physical health damage. Non-dependent abuse.

Fourth character.1

When documentation states use w/o intent or qualifiers of “harmful” or “abuse” F code not assigned, may optionally assign:

Z72. ~ problems related to lifestyle

Note will generally use this code over dependence, unless documentation specifically states dependence

Question 7

Dependence syndrome

Answer 7

Includes abuse of psychoactive substance, difficult to control, use and increasing tolerance to substance

May see a phrase, addiction or alcoholism

Fourth character.2

Question 8

Amnesiac

Answer 8

Fourth character .6

Question 9

Residual and late onset psychotic disorders

Answer 9

Fourth character .7

Question 10

Other fourth character code in mental and behavioral disorders

Answer 10

.8

Question 11

Unspecified fourth character code and mental and behavior disorders

Answer 11

.9

Question 12

Unspecified fourth character code

Answer 12

.9

Question 13

Poisoning and overdoses

Answer 13

Not coded to f block
Code to poisoning
- t codes

Then three external cause codes:
- Mechanism of injury
- Place
- Activity

Question 14

History of alcohol abuse

Answer 14

Z86.40 personal history of alcohol abuse ( 3/op)

Versus

F. 10.2 * mental and behavioral disorder due to use of alcohol dependent syndrome*

Code assignment will depend on chart documentation and your facilities directives

Question 15

Dependence on tobacco

Answer 15

Often one of:
Z72.0 ~ tobacco use
Z86.42~ personal history of tobacco abuse ( 3/op)
- optional diagnosis

Dependent use of tobacco as mental health disorder F17.2 only coded when clearly stated and specified in documentation

Question 16

Clinically significant physical or mental health condition related to psychoactive substance use

Answer 16

Mandatory code assignment from f10 to f19

Question 17

Polysubstance abuse

Answer 17

When diagnosis indicates polysubstance and individual substances are documented assigned codes from f10 to f19 to identify each substance

When diagnosis indicates polysubstance and individual substances are not documented in diagnostic statement, assign code from category f19.98

Question 18

Schizophrenia

Answer 18

Classified to f20.^

Fourth character determines dominant presenting features
If subtype not documented, code to f20.9

Question 19

Acute schizophrenia like psychotic disorders

Answer 19

“acute schizophrenia” we’re only one psychotic episode occurs

F23.2~ acute schizophrenia like psychotic disorders

Question 20

Schizoaffective disorders

Answer 20

Cases which do not meet diagnostic criteria for either schizophrenia or mood disorders

F25~ schizoaffective disorders

Question 21

Affective (mood) disorders

Answer 21

** cyclic recurring mood changes classifieds to**
F31.^ ~ bipolar effective disorder

** Single manic episode (no previous effective episode) **
F30.^ ~ manic episode

** F32.^ ~ Depressive episode**
-Fourth character identifies degree of depression also called depression reaction
Includes depression NOS

F33.^~ recurrent depressive episode
Diagnosis of mono/unipolar depression describes the current episodes of depression with no previous episode of mania

** F34.1~ dysthymia**
Depressive mood disorder of a chronic course and early/ insidious onsets (childhood/ early adult)

Question 22

Electroconvulsive therapy (ECT)

Answer 22

Always assume external

1.AN.09.JA-DV ~ stimulation brain using external electrical stimulation (for shock or convulsion)

Done under a general anesthetic mandatory to code both DAD and NACRS

IF PERFORMED MULTIPLE TIMES DURING EPISODE OF CARE MANDATORY TO ASSIGN FIRST THREE ONLY

Question 23

Ketamine therapy

Answer 23

Classified to:
1.ZZ.35.HA-P1 ~ pharmacotherapy, total body, percutaneous approach, using anesthetic agent

Question 24

Neurotic stress-related and somatiform disorders

Answer 24

F40 to f48

Includes phobias anxiety disorders, obsessive-compulsive disorders

Question 25

Mixed anxiety depression, versus anxiety with depression

Answer 25

Mixed anxiety and depressive disorder: F41.2 Anxiety with depression: F41.9 F32.9 - anxiety and depression coded separately in this case

Question 26

Obsessive compulsive disorder versus obsessive-compulsive behavior

Answer 26

OCD: F42.^ Obsessive compulsive behavior: R46.80

Question 27

Stress related and adjustment disorders

Answer 27

Includes: Adjustment disorder/reaction Reaction disorder Emotional crisis Post-traumatic stress disorder Grief and stress reaction Coded to: F43.^ ~ reaction to severe stress and adjustment disorders

Question 28

Dissociative disorders

Answer 28

F44.^

Question 29

Neurotic stress related and somatiform disorders -psychogenic

Answer 29

Includes signs and symptoms documented as psychogenic F45.3 ~ somatiform autonomic dysfunction F45.4 ~ persistent somatiform pain disorder

Question 30

Malingerer

Answer 30

Z76.5 ~ malingerer (conscious simulation)

Question 31

Factitious disorder

Answer 31

Create symptoms/feign illness with no obvious motivation F68.1 ~ intentional production or fainting of symptoms or disabilities either physical or psychological (factitious disorder)

Question 32

Behavioral syndromes

Answer 32

Includes disorders related to: - sleeping -Eating -Sexual activity -Postnatal period F50 to f59 ~ behavioral syndrome associated with physiological disturbances and physical factors

Question 33

Physiological disorder with psychogenic component or exacerbation

Answer 33

Includes physical disorders which themselves are classified to other chapters in ICD-10ca and are documented as psychogenic Use additional code to identify the associated physical disorder F54 ~ psychological and behavior factors associated with disorders or diseases classified elsewhere

Question 34

Personality and behavior disorders

Answer 34

Types of personality disorders include: - paranoid -Schizoid -Schizotypal -Borderline - histrionic -Narcissistic -Avoidant -Dependent F60 to f-69 ~ disorders of adult personality and behavior

Question 35

Gender dysphoria

Answer 35

Refers to a psychological stress associated with the discomfort of being transgender

Question 36

Patient admitted for gender reassignment procedure

Answer 36

Mrdx/mp when person admitted for gender reassignment procedure: Z41.80 ~ procedures for transgender assignment

Question 37

Suicidal ideation

Answer 37

Includes suicidal ideation without documentation of the underlying mental health disorder Per excludes, this is NOT ASSIGNED IF UNDERLYING CONDITION IS DOCUMENTED R45.8 ~ other symptoms and signs involving emotional state

Question 38

Substances - synthetic versus non-synthetic unspecified

Answer 38

If unspecified assume synthetic