20 - Other Mental Disorders and Additional Codes

Other Mental Disorders and Additional Codes

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Other Mental Disorders and Additional Codes This chapter provides diagnostic codes for psychiatric presentations that are mental disorders (i.e., symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning) but that do not meet diagnostic requirements for any of the mental disorders in the prior Section II chapters. These codes allow for the documentation and coding of these otherwise unclassified mental disorders. This chapter also includes an additional code, “No diagnosis or condition,” for situations in which the individual has been evaluated and it is determined that no mental disorder or condition is present. The categories 1) other specified mental disorder due to another medical condition and 2) unspecified mental disorder due to another medical condition are for presentations for which it has been determined that the psychiatric symptoms (e.g., dissociative symptoms) are a direct physiological consequence of another medical condition but do not otherwise meet diagnostic criteria for any of the prior Section II mental disorders due to another medical condition. For the diagnosis of other specified or unspecified mental disorder due to another medical condition, it is necessary to code and list the medical condition first (e.g., B20 HIV disease), followed by the applicable code for either other specified or unspecified mental disorder due to another medical condition. The categories 1) other specified mental disorder and 2) unspecified mental disorder are residual categories used when all of the following considerations are met: the psychiatric presentation is a mental disorder (i.e., the symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning); the presentation does not meet diagnostic criteria for any of the specific mental disorders in Section II; neither does the presentation meet the definitional requirements of any of the other specified and unspecified mental disorder categories presented in Section II; and no other mental disorder diagnosis applies. As is the case with other specified and unspecified categories throughout DSM-5, the other specified category is used when the clinician chooses to specify the specific reason that the presentation does not meet the criteria for any of the existing categories (e.g., other specified mental disorder due to complex partial seizures, with dissociative symptoms), and the unspecified category is used when the clinician chooses not to specify the reason. Other Specified Mental Disorder Due to Another Medical Condition F06.8 This category applies to presentations in which symptoms characteristic of a mental

disorder due to another medical condition that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any specific mental disorder attributable to another medical condition. The other specified mental disorder due to another medical condition category is used in situations in which the clinician chooses to communicate the specific reason that the presentation does not meet the criteria for any specific mental disorder attributable to another medical condition. This is done by recording the name of the disorder, with the specific etiological medical condition inserted in place of “another medical condition,” followed by the specific symptomatic manifestation that does not meet the criteria for any specific mental disorder due to another medical condition. Furthermore, the diagnostic code for the specific medical condition must be listed immediately before the code for the other specified mental disorder due to another medical condition. For example, dissociative symptoms due to complex partial seizures would be coded and recorded as G40.209 complex partial seizures, F06.8 other specified mental disorder due to complex partial seizures, dissociative symptoms. An example of a presentation that can be specified using the “other specified” designation is the following: Dissociative symptoms: This includes symptoms occurring, for example, in the context of complex partial seizures. Unspecified Mental Disorder Due to Another Medical Condition F09 This category applies to presentations in which symptoms characteristic of a mental disorder due to another medical condition that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any specific mental disorder due to another medical condition. The unspecified mental disorder due to another medical condition category is used in situations in which the clinician chooses not to specify the reason that the criteria are not met for a specific mental disorder due to another medical condition, and includes presentations for which there is insufficient information to make a more specific diagnosis (e.g., in emergency room settings). This is done by recording the name of the disorder, with the specific etiological medical condition inserted in place of “another medical condition.” Furthermore, the

diagnostic code for the specific medical condition must be listed immediately before the code for the unspecified mental disorder due to another medical condition. For example, dissociative symptoms due to complex partial seizures would be coded and recorded as G40.209 complex partial seizures, F09 unspecified mental disorder due to complex partial seizures. Other Specified Mental Disorder F99 This category applies to presentations in which symptoms characteristic of a mental disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any specific mental disorder. The other specified mental disorder category is used in situations in which the clinician chooses to communicate the specific reason that the presentation does not meet the criteria for any specific mental disorder. This is done by recording “other specified mental disorder” followed by the specific reason. Unspecified Mental Disorder F99 This category applies to presentations in which symptoms characteristic of a mental disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any mental disorder. The unspecified mental disorder category is used in situations in which the clinician chooses not to specify the reason that the criteria are not met for a specific mental disorder, and includes presentations for which there is insufficient information to make a more specific diagnosis (e.g., in emergency room settings). Additional Codes Z03.89 No Diagnosis or Condition This code applies to situations in which the person has been evaluated and it is determined that no mental disorder or condition is present.