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Illinois Department of Human Services Information Management and Development Unified Health Systems Section Provider Claims Unit

Reporting of Community Services and Community Mental Health Billing Systems

DMH Service Activity Codes and Billing Diagnosis Codes

CONTENTS:

< < < < Service Activity Code Assignments For Reporting of Grant-Funded Community Mental Health Services & Medicaid Rule 132 Valid Activity Codes to Report Total Dollars Spent on Client Obsolete Mental Health Activity Codes Listing of DSM-IV Diagnoses and ICD-9 Codes for the Use in the Community MH Billing System

SERVICE ACTIVITY CODE ASSIGNMENTS FOR REPORTING OF GRANT-FUNDED COMMUNITY MENTAL HEALTH SERVICES & MEDICAID RULE 132 Current Activity Code PreFY08

Bill Option

Definition

SERVICE NEEDS EVALUATION

Treatment Plan Development, Review and Modification (MHP staff) Treatment Plan Development, Review and Modification (QMHP staff) Mental Health Assessment, Non-Physician (MHP staff)

0X

0C

0C

R

The development of a plan to deliver specific mental health services to a client. This service is performed by a MHP. The development of a plan to deliver specific mental health services to a client. This service is performed by a QMHP. Identification of the client's mental health service needs and recommendations for treatment. This service is performed by a MHP and may include: - Mental Health Assessment (previous code 03) - Client Intake (previous code 0A) - Mental Health Social History (previous code 04)

0D

0D

R

0M

0M

R

Mental Health Assessment, Non-Physician (QMHP staff)

0Q

0Q

R

Identification of the client's mental health service needs and recommendations for treatment. This service is performed by a QMHP and may include: - Mental Health Assessment (previous code 03) - Client Intake (previous code 0A) - Mental Health Social History (previous code 04)

Psychological Evaluation (licensed psychologist) Psychiatric Evaluation Psychological Evaluation (master's level staff)

01 02 07

01 02 07

R D R

Conducting and documenting a psychological evaluation. This service is performed by a licensed clinical psychologist. DIRECT DPA BILLING ONLY - Conducting a psychiatric evaluation by a physician on a face to face basis. Administering standardized testing as part of a psychological evaluation. This service is performed by a master's level professional under the supervision of the licensed clinical psychologist. Conducting tests of a client's vocational abilities and/or aptitude or administering IQ and other tests of a client's educational aptitudes, strengths, and shortcomings. Other

Vocational Testing/ Evaluation, Educational Testing Other 09

0B#

N

09

D

Billing Options:

R - Rehabilitation T - Targeted Case Management N - Non-Medicaid D - Service Reporting Only

* Activity Code is effective with services provided starting 07-01-2007 # Activity Code is obsolete with services provided starting 07-01-2007 ## Activity Code is obsolete with services provided starting 10-01-2007 Page 1

SERVICE ACTIVITY CODE ASSIGNMENTS FOR REPORTING OF GRANT-FUNDED COMMUNITY MENTAL HEALTH SERVICES & MEDICAID RULE 132 Current Activity Code PreFY08

Bill Option

Definition

CRISIS INTERVENTION

Crisis Intervention (Multiple Staff) Crisis Intervention

1X 1A 10 1A 10 R R Crisis intervention services that require more than one staff person to provide the crisis services. Services provided to interrupt a crisis experience. These services may include: - Crisis Intervention Assessment (previous code 11) - Therapy/Counseling (previous code 12) - Other Prescreening/Referral (previous code 14) - Consultation (previous code 15) - Collateral Contact (previous code 16)

State-Operated Facility Prescreening/ Referral Intensive Family-based Services

13

13

R

Gathering information and making decisions regarding client's appropriateness for admission to a state-operated facility inpatient unit. Interacting with the client to restore the client to prior levels of functioning, to reduce the risk of more restrictive treatment for the client such as psychiatric hospitalization, to reduce the risk of alternative placement or to avert a family crisis. Services may only be provided to child or adolescent enrolled in the SASS program by the CARES. Interacting with the client to restore the client to prior levels of functioning, to reduce the risk of more restrictive treatment for the client such as psychiatric hospitalization, to reduce the risk of alternative placement or to avert a family crisis. More than one staff person is required to provide the services. Services may only be provided to child or adolescent enrolled in the SASS program by the CARES. Other

17#

R

Intensive Family-based Services (Multiple Staff)

18#

R

Other

19

19

D

Billing Options:

R - Rehabilitation T - Targeted Case Management N - Non-Medicaid D - Service Reporting Only

* Activity Code is effective with services provided starting 07-01-2007 # Activity Code is obsolete with services provided starting 07-01-2007 ## Activity Code is obsolete with services provided starting 10-01-2007 Page 2

SERVICE ACTIVITY CODE ASSIGNMENTS FOR REPORTING OF GRANT-FUNDED COMMUNITY MENTAL HEALTH SERVICES & MEDICAID RULE 132 Current Activity Code PreFY08

Bill Option

Definition

MENTAL HEALTH TREATMENT

Therapy/Counseling, Individual (MHP) Therapy/Counseling, Group (MHP) Therapy/Counseling, Family (MHP) Therapy/Counseling, Individual (QMHP) Therapy/Counseling, Group (QMHP) Therapy/Counseling, Family (QMHP) Psychotropic Medication Administration (APN staff) Psychotropic Medication Administration (LPN or RN staff) Psychotropic Medication Monitoring (APN staff) Psychotropic Medication Monitoring (Physician) Psychotropic Medication Monitoring (Non-Physician/ Non-APN staff) Other

2X

2A 2B 2C

2A 2B 2C

R R R

Therapy or counseling with only the identified client present. This service is performed by a MHP. Therapy or counseling in a group setting. This service is performed by a MHP. Therapy or counseling with only the identified client and identified family members or with a couple. This service is performed by a MHP. Therapy or counseling with only the identified client present. This service is performed by a QMHP. Therapy or counseling in a group setting This service is performed by a QMHP. Therapy or counseling with only the identified client and identified family members or with a couple. This service is performed by a QMHP. The actual administration of medication by an advanced practice nurse. The actual administration of medication by a LPN or RN.

21 22 23

21 22 23

R R R

2D

2D

R

25

25

R

2E

2E

R

Monitoring & evaluating target symptom response, adverse effects & new target symptoms or medication by an advanced practice nurse. Monitoring & evaluating target symptom response, adverse effects & new target symptoms or medication by a physician. Monitoring & evaluating target symptom response, adverse effects & new target symptoms or medication by staff designated in writing by a physician or advanced practice nurse per the collaborative agreement. Other

2F

2F

R

26

26

R

29

29

D

Billing Options:

R - Rehabilitation T - Targeted Case Management N - Non-Medicaid D - Service Reporting Only

* Activity Code is effective with services provided starting 07-01-2007 # Activity Code is obsolete with services provided starting 07-01-2007 ## Activity Code is obsolete with services provided starting 10-01-2007 Page 3

SERVICE ACTIVITY CODE ASSIGNMENTS FOR REPORTING OF GRANT-FUNDED COMMUNITY MENTAL HEALTH SERVICES & MEDICAID RULE 132 Current Activity Code PreFY08

Bill Option

Definition

ADAPTIVE/SOCIAL DEVELOPMENTAL REHABILITATION

Psychotropic Medication Training (Individual)

3X

31

31

R

Training the client or the client's family or guardian to administer the client's medication, monitor proper levels and dosage and watch for side effects. This service is performed by staff designated in writing by the physician. Training the client or the client's family or guardian to administer the client's medication, monitor proper levels and dosage and watch for side effects. This service is performed by an advanced practice nurse. In a group setting, training the client or the client's family or guardian to administer the client's medication, monitor proper levels and dosage and watch for side effects. This service is performed by staff designated in writing by the physician. In a group setting, training the client or the client's family or guardian to administer the client's medication, monitor proper levels and dosage and watch for side effects. This service is performed by an advanced practice nurse. Psychosocial Rehabilitation services provided to an individual by RSA staff. Psychosocial Rehabilitation services provided to an individual by MHP staff. Psychosocial Rehabilitation services provided to an individual by QMHP staff. Psychosocial Rehabilitation services provided in a group setting by RSA staff. Psychosocial Rehabilitation services provided in a group setting by MHP staff. Psychosocial Rehabilitation services provided in a group setting by QMHP staff. Services provided to an individual focusing on adaptive functioning deficits which may be social, emotional, cognitive, interpersonal and/or behavioral. Services provided to the family or the family and the client focusing on adaptive functioning deficits which may be social, emotional, cognitive, interpersonal, and /or behavioral. Training clients to utilize their free time. Individually provided activities intended to result in improving and/or maintaining the individual's ability to function in a variety of interpersonal situations, including the family, school, or community.

Psychotropic Medication Training (Individual, APN staff)

3A

3A

R

Psychotropic Medication Training (Group)

3B

3B

R

Psychotropic Medication Training (Group, APN staff)

3C

3C

R

Psychosocial Rehabilitation (Individual, RSA staff) Psychosocial Rehabilitation (Individual, MHP staff) Psychosocial Rehabilitation (Individual, QMHP staff) Psychosocial Rehabilitation (Group, RSA staff) Psychosocial Rehabilitation (Group, MHP staff) Psychosocial Rehabilitation (Group, QMHP staff) Skills Training and Development (Individual) Skills Training and Development (Group) Recreational Therapeutic Behavioral Services (Individual)

3R* 3M* 3Q* 3G* 3H* 3J* 32#

R R R R R R R

38#

R

35

35 36#

D R

Billing Options:

R - Rehabilitation T - Targeted Case Management N - Non-Medicaid D - Service Reporting Only

* Activity Code is effective with services provided starting 07-01-2007 # Activity Code is obsolete with services provided starting 07-01-2007 ## Activity Code is obsolete with services provided starting 10-01-2007 Page 4

SERVICE ACTIVITY CODE ASSIGNMENTS FOR REPORTING OF GRANT-FUNDED COMMUNITY MENTAL HEALTH SERVICES & MEDICAID RULE 132 Current Activity Code Therapeutic Behavioral Services (Group) PreFY08

Bill Option R

Definition Group activities intended to result in improving and/or maintaining the individual's ability to function in a variety of interpersonal situations including in the family, school, or community, including peer support and self-help groups. Group activities intended to result in improving and/or maintaining the individual's ability to function in a variety of interpersonal situations including in the family, school, or community, including peer support and self-help groups. Activity therapy services are individually-provided, direct interactions with the client or on behalf of the client with a member of the client's family, with such interactions intended to result in improving or maintaining the client's ability to function in a variety of interpersonal situations, including in the family, school or community. Activity therapy services may include activities using art, music, drama, play or recreation. Activity therapy services are direct interactions in a group setting with the client or on behalf of the client with a member of the client's family, with such interactions intended to result in improving or maintaining the client's ability to function in a variety of interpersonal situations, including in the family, school or community. Activity therapy services may include activities using art, music, drama, play or recreation. Engagement, pre-vocational and vocational activities other than "Vocational Testing/Evaluation (code 0B) and activities integrated within a Supported Employment Process (code 34). Individually provided activities for a specific client, such as job development, job coaching and job placement, when provided under the following conditions: placement based on consumer job preferences, competitive employment in integrated work settings, on-going supports as needed, and integration of supported employment services with other mental health services. Group activities such as job development, job coaching and job placement, when provided under the following conditions: placement based on consumer job preferences, competitive employment in integrated work settings, on-going supports as needed, and integration of supported employment services with other mental health services. Other

37#

Therapeutic Behavioral Services (Group)

37#

R

Activity Therapy (Individual)

3E#

R

Activity Therapy (Group)

3F#

R

Job/Vocational

33#

N

Supported Employment (Individual)

34#

N

Supported Employment (Group)

3D#

N

Other

39

39

D

Billing Options:

R - Rehabilitation T - Targeted Case Management N - Non-Medicaid D - Service Reporting Only

* Activity Code is effective with services provided starting 07-01-2007 # Activity Code is obsolete with services provided starting 07-01-2007 ## Activity Code is obsolete with services provided starting 10-01-2007 Page 5

SERVICE ACTIVITY CODE ASSIGNMENTS FOR REPORTING OF GRANT-FUNDED COMMUNITY MENTAL HEALTH SERVICES & MEDICAID RULE 132 Current Activity Code PreFY08

Bill Option

Definition

SELF-HELP AND INDIVIDUAL CARE GRANT PROCESS

Group Organizing Activities Group Facilitator/ Leader Other

4X

41 42 49

41 42 49

D D D

Planning, starting, scheduling, recruiting, advertising and otherwise organizing self-help groups. Acting as a leader for self-help group. Other

Billing Options:

R - Rehabilitation T - Targeted Case Management N - Non-Medicaid D - Service Reporting Only

* Activity Code is effective with services provided starting 07-01-2007 # Activity Code is obsolete with services provided starting 07-01-2007 ## Activity Code is obsolete with services provided starting 10-01-2007 Page 6

SERVICE ACTIVITY CODE ASSIGNMENTS FOR REPORTING OF GRANT-FUNDED COMMUNITY MENTAL HEALTH SERVICES & MEDICAID RULE 132 Current Activity Code PreFY08

Bill Option

Definition

CASE MANAGEMENT

Transition Linkage and Aftercare (MHP staff) Transition Linkage and Aftercare (QMHP staff) Mandated Follow-Up (MHP staff) Mandated Follow-Up (QMHP staff) Administer LOCUS Case Management (RSA staff)

5X 5A 5A T Referral and linkage to mental health services or to basic resources to facilitate an effective transition in living arrangement. This service is performed by a MHP. Referral and linkage to mental health services or to basic resources to facilitate an effective transition in living arrangement. This service is performed by a QMHP. Mandated follow-up with clients in Long Term Care Facilities. This service is performed by a MHP. Mandated follow-up with clients in Long Term Care Facilities. This service is performed by a QMHP. Administering and completing a Level of Care Utilization System (LOCUS) assessment. Case Management services performed by a RSA. These services may include: - ICG Application Assistance (previous code 45) - Post Determination Process for ICG (previous code 47) - Assessment (previous code 51) - Home Visit/Outreach (previous code 52) - Monitoring (previous code 54) - Support (previous code 56) - Advocacy (previous code 57) - Service Planning (previous code 58)

5B

5B

T

5C 5D 5L* 5R

5C 5D

T T T

5R

T

Case Management (MHP staff)

5M

5M

T

Case Management services performed by a MHP. These services may include: - ICG Application Assistance (previous code 45) - Post Determination Process for ICG (previous code 47) - Assessment (previous code 51) - Home Visit/Outreach (previous code 52) - Monitoring (previous code 54) - Support (previous code 56) - Advocacy (previous code 57) - Service Planning (previous code 58)

Other

59

59

D

Other

Billing Options:

R - Rehabilitation T - Targeted Case Management N - Non-Medicaid D - Service Reporting Only

* Activity Code is effective with services provided starting 07-01-2007 # Activity Code is obsolete with services provided starting 07-01-2007 ## Activity Code is obsolete with services provided starting 10-01-2007 Page 7

SERVICE ACTIVITY CODE ASSIGNMENTS FOR REPORTING OF GRANT-FUNDED COMMUNITY MENTAL HEALTH SERVICES & MEDICAID RULE 132 Current Activity Code PreFY08

Bill Option

Definition

CASE MANAGEMENT CLIENT CENTERED CONSULTATION /COMMUNITY EDUCATION

Client-Centered Consultation (RSA staff)

6X

6R

6R

T

Client-centered consultation services performed by a RSA. These services may include: - Consultation with Law Enforcement (previous code 62) - Consultation with LTC Facilities (previous code 63) - Consultation with Educational Institutions (previous code 64) - Consultation with Other Providers (previous code 65) - Clinical Staffings (previous code 67) - Consultation with Family and/or Collaterals (previous code 68)

Client-Centered Consultation (MHP staff)

6M

6M

T

Client-centered consultation services performed by a MHP. These services may include: - Consultation with Law Enforcement (previous code 62) - Consultation with LTC Facilities (previous code 63) - Consultation with Educational Institutions (previous code 64) - Consultation with Other Providers (previous code 65) - Clinical Staffings (previous code 67) - Consultation with Family and/or Collaterals (previous code 68)

Community Education/ Training

61#

D

Informing and educating the public, service organization, other providers, etc., how they can help prevent, make referrals, treat or otherwise serve the mentally ill. Contacting community organizations seeking persons who might benefit from mental health services and currently receiving them. Other

Case Finding

66#

D

Other

69

69

D

Billing Options:

R - Rehabilitation T - Targeted Case Management N - Non-Medicaid D - Service Reporting Only

* Activity Code is effective with services provided starting 07-01-2007 # Activity Code is obsolete with services provided starting 07-01-2007 ## Activity Code is obsolete with services provided starting 10-01-2007 Page 8

SERVICE ACTIVITY CODE ASSIGNMENTS FOR REPORTING OF GRANT-FUNDED COMMUNITY MENTAL HEALTH SERVICES & MEDICAID RULE 132 Current Activity Code PreFY08

Bill Option

Definition

ADMINISTRATION/ SUPPORT

Oral Interpretation and Sign Language

7X

7A

7A

N

Interpretation performed by a person skilled in sign language or oral interpretation with the goal of facilitating communication with a deaf, hearing-impaired or limited-English proficient person. Illinois Sign language interpreters are to be registered with the Illinois Deaf and Hard of Hearing Commission and to have a level of certification consistent with the necessary skills for interpreting in such settings. Services to identify adults, adolescents and children in need of services who are suspected to have a serious mental illness or serious emotional disorder; and who have not currently consented to receive services, require engagement into services, are disengaging from services or have disengaged and require re-engagement into services. Services to identify adults, adolescents and children in need of services who are suspected to have a serious mental illness or serious emotional disorder; and who have not currently consented to receive services, require engagement into services, are disengaging from services or have disengaged and require reengagement into services. These services can be provided by multiple staff. Services that educate and train community stakeholders who frequently interact with individuals with a suspected serious mental illness or serious emotional disorder on how to understand, approach and work with the population during the performance of their duties. Services that educate and train community stakeholders, who frequently interact with individuals with a suspected serious mental illness or serious emotional disorder on how to understand, approach and work with the population during the performance of their duties. These services can be provided by multiple staff. Non-Clinical Staff Meetings Individual Client Transportation Staff Supervision Travel Staff Development/Training Research and Program Evaluation Administrative Functions Client-Related Support Other

Outreach and Engagement

7B*

D

Outreach and Engagement (multiple staff)

7C*

D

Stakeholder Education

7D*

D

Stakeholder Education (multiple staff)

7E*

D

Non-Clinical Staff Meetings Individual Client Transportation Staff Supervision Travel Staff Development/ Training Research and Program Evaluation Administration Functions Client-Related Support Other

71 72 73 74 75 76 77 78 79

71 72 73 74 75 76 77 78 79

D D D D D D D D D

Billing Options:

R - Rehabilitation T - Targeted Case Management N - Non-Medicaid D - Service Reporting Only

* Activity Code is effective with services provided starting 07-01-2007 # Activity Code is obsolete with services provided starting 07-01-2007 ## Activity Code is obsolete with services provided starting 10-01-2007 Page 9

SERVICE ACTIVITY CODE ASSIGNMENTS FOR REPORTING OF GRANT-FUNDED COMMUNITY MENTAL HEALTH SERVICES & MEDICAID RULE 132 Current Activity Code PreFY08

Bill Option

Definition

DAY TREATMENT PROGRAMS

Mental Health Day Treatment (Adults) Mental Health Day Treatment (Children and Adolescents)

8X

8A#

R

8B#

Extended Treatment & Rehabilitation Services (previous code 86) A schedule of interventions, including therapy, adaptive functioning, stabilization and development interventions, available for a minimum of four hours daily with services focused on the restoration of client functioning, and reintegration into the family and community. Psychosocial Day Program Services (previous code 87) A range of services provided on the basis of the individual's needs, available a minimum of four hours a day, five days a week. Services are focused on age appropriate or independent role functioning and include individual or group counseling, individual or group adaptive functioning, stabilization, and developmental interventions; and community integration and re-integration.

Intensive Outpatient (Adults) Intensive Outpatient (Children and Adolescents) Other

81 85 89

81 85 89

R R D

Intensive outpatient services provided to adults. Intensive outpatient services provided to children and adolescents. Other

Billing Options:

R - Rehabilitation T - Targeted Case Management N - Non-Medicaid D - Service Reporting Only

* Activity Code is effective with services provided starting 07-01-2007 # Activity Code is obsolete with services provided starting 07-01-2007 ## Activity Code is obsolete with services provided starting 10-01-2007 Page 10

SERVICE ACTIVITY CODE ASSIGNMENTS FOR REPORTING OF GRANT-FUNDED COMMUNITY MENTAL HEALTH SERVICES & MEDICAID RULE 132 Current Activity Code PreFY08

Bill Option

Definition

ASSERTIVE COMMUNITY TREATMENT (ACT)

Assertive Community Treatment, evidence-based (Individual) Assertive Community Treatment, evidence-based (Group) Assertive Community Treatment - Vocational Services (Individual)

9X

9A*

R

ACT services meeting the evidence-based model, provided on an individual basis. ACT services meeting the evidence-based model, provided in a group setting. Work and education related services to helping an individual understand the value of employment and additional education, to find and achieve meaningful employment or education in communitybased job and education sites. These services are provided on an individual basis. Work and education related services to helping an individual understand the value of employment and additional education, to find and achieve meaningful employment or education in community-based job and education sites. These services are provided in a group setting. ACT services that do not meet the evidence-based model. These services may include: - Assessment and Service Planning (previous code 91) - Referral and Linkage (previous code 92) - Counseling (previous code 93) - Support In Other Environments (previous code 94) - Advocacy (previous code 95) - Support In Developing Natural Community Supports; Activities of Daily Living (previous code 96)

9B*

R

9C*

N

Assertive Community Treatment - Vocational Services (Group)

9D*

N

Assertive Community Treatment

90 ##

90 ##

R

Transportation Crisis Other 99

97# 98# 99

R R D

Assessing and teaching the individual to use public transportation. Providing intervention and support in times of crisis, including 24hour crisis response; providing on-going support following a crisis. Other

Billing Options:

R - Rehabilitation T - Targeted Case Management N - Non-Medicaid D - Service Reporting Only

* Activity Code is effective with services provided starting 07-01-2007 # Activity Code is obsolete with services provided starting 07-01-2007 ## Activity Code is obsolete with services provided starting 10-01-2007 Page 11

SERVICE ACTIVITY CODE ASSIGNMENTS FOR REPORTING OF GRANT-FUNDED COMMUNITY MENTAL HEALTH SERVICES & MEDICAID RULE 132 Current Activity Code PreFY08

Bill Option

Definition

COMMUNITY SUPPORT

Community Support (Individual, MHP staff) Community Support (Individual, QMHP staff) Community Support (Individual, RSA staff) Community Support Team Community Support (Group, RSA staff) Community Support (Group, MHP staff) Community Support (Group, QMHP staff) Community Support Residential (Individual, RSA staff) Community Support Residential (Individual, MHP staff) Community Support Residential (Individual, QMHP staff) Community Support Residential (Group, RSA staff) Community Support Residential (Group, MHP staff) Community Support Residential (Group, QMHP staff) Other

SX SM* SQ* SR* ST* S1* S2* S3* S4* S5* S6* S7* S8* S0* S9* R R R R R R R R R R R R R D Community Support services provided on an individual basis by MHP staff. Community Support services provided on an individual basis by QMHP staff. Community Support services provided on an individual basis by RSA staff. Community Support Team services. Community Support services provided in a group setting by RSA staff. Community Support services provided in a group setting by MHP staff. Community Support services provided in a group setting by QMHP staff. Community Support services in public payer designated residential settings provided on an individual basis by RSA staff. Community Support services in public payer designated residential settings provided on an individual basis by MHP staff. Community Support services in public payer designated residential settings provided on an individual basis by QMHP staff. Community Support services in public payer designated residential settings provided in a group setting by RSA staff. Community Support services in public payer designated residential settings provided in a group setting by MHP staff. Community Support services in public payer designated residential settings provided in a group setting by QMHP staff. Other

Billing Options:

R - Rehabilitation T - Targeted Case Management N - Non-Medicaid D - Service Reporting Only

* Activity Code is effective with services provided starting 07-01-2007 # Activity Code is obsolete with services provided starting 07-01-2007 ## Activity Code is obsolete with services provided starting 10-01-2007 Page 12

SERVICE ACTIVITY CODE ASSIGNMENTS FOR REPORTING OF GRANT-FUNDED COMMUNITY MENTAL HEALTH SERVICES & MEDICAID RULE 132 Current Activity Code PreFY08

Bill Option

Definition

VOCATIONAL SERVICES

Vocational Assessment Vocational Engagement (Group)

VX

V1* V2*

N N

Developing a vocational profile to guide client choices in seeking and maintaining competitive employment. Activities for a specific client to engage the client in making a decision to actively seek competitive employment or formal credit/certificate bearing education. These services are delivered in a group setting. Activities for a specific client to engage the client in making a decision to actively seek competitive employment or formal credit/certificate bearing education. These services are delivered on an individual basis. Activities for a specific client, directed toward helping them find and procure a job. These services are delivered in a group setting. Activities for a specific client, directed toward helping them find and procure a job. These services are delivered on an individual basis. Activities for a specific client directed toward helping them keep their job. These services are delivered in a group setting.

Vocational Engagement (Individual)

V3*

N

Job Finding Supports (Group) Job Finding Supports (Individual) Job Retention Supports (Group)

V4* V5*

N N

V6*

N

Job Retention Supports (Individual) Job Leaving/ Termination Supports (Group) Job Leaving/ Termination Supports (Individual) Other

V7* V8*

N N

Activities for a specific client directed toward helping them keep their job. These services are delivered on an individual basis. Activities for a specific client directed toward helping them leave their job or learn from unplanned job loss. These services are delivered in a group setting. Activities for a specific client directed toward helping them leave their job or learn from unplanned job loss. These services are delivered on an individual basis. Other

V0*

N

V9*

D

Billing Options:

R - Rehabilitation T - Targeted Case Management N - Non-Medicaid D - Service Reporting Only

* Activity Code is effective with services provided starting 07-01-2007 # Activity Code is obsolete with services provided starting 07-01-2007 ## Activity Code is obsolete with services provided starting 10-01-2007 Page 13

VALID ACTIVITY CODES TO REPORT TOTAL DOLLARS SPENT ON CLIENT For MH Programs 131, 572, 573, and 574

SASS Flex, Client Transitional Subsidy, Transition to Adult Services, and Psychiatric Medication

Activity Code Bill Option

Definition Temporary assistance for medications, clothing and other basic supplies and temporary housing support for eligible individuals in order to facilitate resettlement in the least restrictive and most community-integrated setting possible. Promotes timely discharges from state and community hospitals by providing basic and temporary resources which are lacking due to a lag in obtaining other funding.

TRANSITIONAL SUBSIDIES AND MEDICATIONS

Utility Payments Rent Transportation Personal Items Housewares and Furniture Psychiatric Medications Non-Psychiatric Medications Other

A1 A2 A3 A4 A5 A6 A7 A9

D D D D D D D D

Payments to a utility company to initiate service for housing for a specific client (includes deposits). Payments to a housing provider to initiate housing for a specific client (includes deposits). Payments for transportation in order to access public assistance offices, medical/psychiatric services, obtain housing and community services, etc. Payments for basic personal supplies such as toiletries and clothing. Payments for minimum necessary housewares and furniture to establish community living. Payments for psychiatric medications that are critical to maintaining stability in the community and that aren't covered by other funding. Payments for non-psychiatric medications that are critical to maintaining stability in the community and that aren't covered by other funding. Other Funds used to purchase adjunctive health, educational and rehabilitative services which are not offered by the provider or readily available from other DHS-funded providers but are necessary to facilitate the client's transition from institutional care to independent, community living and from adolescence to adulthood.

TRANSITION TO ADULT SERVICES

Assessment and Services Planning Referral and Linkage

B1

D

Determining the array of services required by an individual; identifying the services or programs that will best meet the needs identified in the service needs evaluation and which will be incorporated into the ITP. Linkage with resources and services; providing personal support and assistance in gaining access to other mental health services, vocational training, educational services, legal services, employment opportunities, leisure, recreation, religious, and social activities and self-help groups. Accessing and providing training in obtaining medical services, emergency and non-emergency. Providing supportive counseling and problem-solving. Maintaining on-going involvement with the individual during stays in other environments such as state hospitals, convalescent care facilities, jails, community hospitals or rehabilitation centers. Advocating on behalf of the individual; providing information, educational and advocacy services to family members.

B2

D

Counseling Support in Other Environments

B3 B4

D D

Advocacy

B5

D

Page 14

Activity Code Activities of Daily Living B6

Bill Option D

Definition Assisting the individual in developing natural community supports, fostering relationships with non-paid persons in the community such as neighbors, landlords, and volunteers. Assisting individuals with activities of daily living through skills training and acquisition of assistive devices. Assessing and teaching the individual to use public transportation or provide transportation in order to access public assistance offices, medical/psychiatric services, obtain housing and community services, etc. Providing intervention and support in times of crisis, including 24-hour crisis response; providing on-going support following a crisis. Conducting an assessment of a client's vocational abilities, aptitudes, strengths and shortcomings. Vocational training activities for a specific client. Other Flexible funding to purchase alternative therapeutic services which are not offered by the provider or readily available from other DHS-funded providers. These funds will be utilized to augment traditional mental health services where additional supports are needed in order to avoid placing a child in an institutional setting, such as a hospital or residential treatment center.

Provide/Assist with Transportation Crisis Intervention and Support Vocational Assessment Vocational Training Other

B7

D

B8 BA BB B9

D D D D

SASS FLEX SERVICES

Rehabilitation/Stabilization Substance Abuse Services Culturally Specific MH Needs Therapeutic Recreational Activities Behavior Management Intervention Child and Family Support Services Emergency Psychotropic Medication Transportation Other

C1 C2 C3 C4 C5 C6 C7 C8 C9

D D D D D D D D D

Rehabilitation/stabilization where the target behaviors from the treatment plan are being addressed. Substance Abuse services when no other resources are available or appropriate. Culturally specific mental health needs. Therapeutic recreational activities that address target behaviors. Behavior management intervention to ameliorate specific problem behaviors. Child and family support services that address target behaviors. Emergency psychotropic medication for the client/family. Transportation to access mental health and other therapeutic services. Other

Page 15

OBSOLETE MENTAL HEALTH ACTIVITY CODES Effective July 1, 2007

Table 1. Activity Codes Valid for Pre-FY08 Service Dates

These activity codes continue to be valid for dates of service prior to July 1, 2007.

Activity Code 0B 17 18 32 33 34 36 37 38 3D 3E 3F 61 66 8A 8B 97 98 Description Vocational/Educational Testing/Evaluation Intensive Family-Based Services Intensive Family-Based Services - Multiple Staff Skills Training and Development - Individual Adaptive Social Rehabilitation - Vocational Supported Employment - Individual Therapeutic Behavioral Services - Individual Therapeutic Behavioral Services - Group Skills Training and Development - Group Supported Employment - Group Activity Therapy - Individual Activity Therapy - Group Community Education/Training Case Finding Mental Health Day Treatment - Adult Mental Health Day Treatment - Child Assertive Community Treatment - Transportation Assertive Community Treatment - Crisis ** Table 1 **

Table 2. Obsolete Activity Codes for All Service Dates

These activity codes are not valid for any date of service. Data submitted using these codes will be rejected.

Activity Code 03 04 08 0A 11 12 Description Mental Health Assessment Mental Health Social History Treatment Plan Development, Review and Modification Client Intake Crisis Intervention Assessment Crisis Intervention - Therapy and Counseling

Page 16

** Table 2 **

Activity Code 14 15 16 45 47 51 52 53 54 55 56 57 58 62 63 64 65 67 68 82 83 86 87 91 92 93 94 95 96

Description Crisis Intervention - Other Pre-Screening/Referral Crisis Intervention - Consultation Crisis Intervention - Collateral Contact Case Management - ICG Application Assistance Case Management - Post-Determination Process for ICG Case Management - Assessment Case Management - Home Visit/Outreach Case Management - Mandated Follow up Case Management- Monitoring Case Management - Transition Linkage and Aftercare Case Management - Support Case Management - Advocacy Case Management - Service Planning Client-Centered Consultation - Consultation with Law Enforcement Client-Centered Consultation - Consultation with Ltc Facilities Client-Centered Consultation - Consultation with Educational Institutions Client-Centered Consultation - Consultation with Other Providers Client-Centered Consultation - Clinical Staffing Client-Centered Consultation - Consultation with Family And/or Collaterals Mental Health Day Treatment (Adult) - Extended Treatment and Rehabilitation Services Mental Health Day Treatment (Adult) - Psychosocial Day Program Services

** Table 2 **

Mental Health Day Treatment (Children and Adolescents) - Extended Treatment and Rehabilitation Services Mental Health Day Treatment (Children and Adolescents) - Psychosocial Day Program Services Assertive Community Treatment - Assessment and Service Planning Assertive Community Treatment - Referral and Linkage Assertive Community Treatment - Counseling Assertive Community Treatment - Support in Other Environments Assertive Community Treatment - Advocacy Assertive Community Treatment - Support in Developing Natural Community Supports; Activities of Daily Living

Page 17

LISTING OF DSM-IV DIAGNOSES AND ICD-9-CM CODES FOR THE USE IN THE COMMUNITY MH BILLING SYSTEM

DSM-IV ICD-9-CM 295.00 295.01 295.02 295.03 295.04 295.05 295.10 295.11 295.12 295.13 295.14 295.15 295.20 295.21 295.22 295.23 295.24 295.25 295.30 295.31 295.32 295.33 295.34 295.35 295.40 295.41 295.42 295.43 295.44 295.45 295.60 295.61 295.62 295.63 295.64 295.65 295.70 295.71 295.72 295.73 295.74 295.75 295.90 295.91 295.92 295.93 295.94 295.95 296.00 296.01 DESCRIPTION Schizophrenic Disorder, Simple type Schizophrenia, Simple Type, Subchronic Schizophrenia, Simple Type, Chronic Schizophrenia, Simple Type, Subchronic with Acute Exacerbation Schizophrenia, Simple Type, Chronic with Acute Exacerbation Schizophrenia, Simple Type, In Remission Schizophrenia, Disorganized Type Schizophrenia, Disorganized Type, Subchronic Schizophrenia, Disorganized Type, Chronic Schizophrenia, Disorganized Type, Subchronic with Acute Exacerbation Schizophrenia, Disorganized Type, Chronic with Acute Exacerbation Schizophrenia, Disorganized Type, In Remission Schizophrenia, Catatonic Type Schizophrenia, Catatonic Type, Subchronic Schizophrenia, Catatonic Type, Chronic Schizophrenia, Catatonic Type, Subchronic with Acute Exacerbation Schizophrenia, Catatonic Type, Chronic with Acute Exacerbation Schizophrenia, Catatonic Type, In Remission Schizophrenia, Paranoid Type Schizophrenia, Paranoid Type, Subchronic Schizophrenia, Paranoid Type, Chronic Schizophrenia, Paranoid Type, Subchronic with Acute Exacerbation Schizophrenia, Paranoid Type, Chronic with Acute Exacerbation Schizophrenia, Paranoid Type, In Remission Schizophreniform Disorder/Acute Schizophrenic Episode Acute Schizophrenic Episode, Subchronic Acute Schizophrenic Episode, Chronic Acute Schizophrenic Episode, Subchronic With Acute Exacerbation Acute Schizophrenic Episode, Chronic With Acute Exacerbation Acute Schizophrenic Episode, In Remission Schizophrenia, Residual Type Schizophrenia, Residual Type. Subchronic Schizophrenia, Residual Type. Chronic Schizophrenia, Residual Type, Subchronic with Acute Exacerbation Schizophrenia, Residual Type, Chronic with Acute Exacerbation Schizophrenia, Residual Type, In Remission Schizoaffective Disorder Schizoaffective Disorder, Subchronic Schizoaffective Disorder, Chronic Schizoaffective Disorder, Subchronic With Acute Exacerbation Schizoaffective Disorder, Chronic With Acute Exacerbation Schizoaffective Disorder, In Remission Schizophrenia, Undifferentiated Type Schizophrenia, Undifferentiated Type, Subchronic Schizophrenia, Undifferentiated Type, Chronic Schizophrenia, Undifferentiated Type, Subchronic with Acute Exacerbation Schizophrenia, Undifferentiated Type, Chronic with Acute Exacerbation Schizophrenia, Undifferentiated Type, In Remission Bipolar I Disorder, Single Manic Episode, Unspecified Bipolar I Disorder, Single Manic Episode, Mild

Page 18

295.10

295.20

295.30

295.40

295.60

295.70

295.90

296.00 296.01

DSM-IV 296.02 296.03 296.04 296.05 296.06

ICD-9-CM 296.02 296.03 296.04 296.05 296.06 296.10 296.11 296.12 296.13 296.14 296.15 296.16 296.20 296.21 296.22 296.23 296.24 296.25 296.26 296.30 296.31 296.32 296.33 296.34 296.35 296.36 296.40 296.40 296.41 296.42 296.43 296.44 296.45 296.46 296.50 296.51 296.52 296.53 296.54 296.55 296.56 296.60 296.61 296.62 296.63 296.64 296.65 296.66 296.7 296.80 296.81 296.82

DESCRIPTION Bipolar I Disorder, Single Manic Episode, Moderate Bipolar I Disorder, Single Manic Episode, Severe Without Psychotic Features Bipolar I Disorder, Single Manic Episode, Severe With Psychotic Features Bipolar I Disorder, Single Manic Episode, In Partial Remission Bipolar I Disorder, Single Manic Episode, In Full Remission Manic Disorder, Recurrent Episode, Unspecified Manic Disorder, Recurrent Episode, Mild Manic Disorder, Recurrent Episode, Moderate Manic Disorder, Recurrent Episode, Severe, Without Psychotic Features Manic Disorder, Recurrent Episode, With Psychotic Features Manic Disorder, Recurrent Episode, In Partial Remission Manic Disorder, Recurrent Episode, In Full Remission Major Depressive Disorder, Single Episode, Unspecified Major Depressive Disorder, Single Episode, Mild Major Depressive Disorder, Single Episode, Moderate Major Depressive Disorder, Single Episode, Severe Without Psychotic Features Major Depressive Disorder, Single Episode, Severe With Psychotic Features Major Depressive Disorder, Single Episode, In Partial Remission Major Depressive Disorder, Single Episode, In Full Remission Major Depressive Disorder, Recurrent, Unspecified Major Depressive Disorder, Recurrent, Mild Major Depressive Disorder, Recurrent, Moderate Major Depressive Disorder, Recurrent, Severe Without Psychotic Features Major Depressive Disorder, Recurrent, Severe With Psychotic Features Major Depressive Disorder, Recurrent, In Partial Remission Major Depressive Disorder, Recurrent, In Full Remission Bipolar I Disorder, Most Recent Episode Manic, Unspecified Bipolar I Disorder, Most Recent Episode Hypomanic Bipolar I Disorder, Most Recent Episode Manic, Mild Bipolar I Disorder, Most Recent Episode Manic, Moderate Bipolar I Disorder, Most Recent Episode Manic, Severe Without Psychotic Features Bipolar I Disorder, Most Recent Episode Manic, Severe With Psychotic Features Bipolar I Disorder, Most Recent Episode Manic, In Partial Remission Bipolar I Disorder, Most Recent Episode Manic, In Full Remission Bipolar I Disorder, Most Recent Episode Depressed, Unspecified Bipolar I Disorder, Most Recent Episode Depressed, Mild Bipolar I Disorder, Most Recent Episode Depressed, Moderate Bipolar I Disorder, Most Recent Episode Depressed, Severe Without Psychotic Features Bipolar I Disorder, Most Recent Episode Depressed, Severe With Psychotic Features Bipolar I Disorder, Most Recent Episode Depressed, In Partial Remission Bipolar I Disorder, Most Recent Episode Depressed, In Full Remission Bipolar I Disorder, Most Recent Episode Mixed, Unspecified Bipolar I Disorder, Most Recent Episode Mixed, Mild Bipolar I Disorder, Most Recent Episode Mixed, Moderate Bipolar I Disorder, Most Recent Episode Mixed, Severe Without Psychotic Features Bipolar I Disorder, Most Recent Episode Mixed, Severe With Psychotic Features Bipolar I Disorder, Most Recent Episode Mixed, In Partial Remission Bipolar I Disorder, Most Recent Episode Mixed, In Full Remission Bipolar I Disorder, Most Recent Episode Unspecified Bipolar Disorder NOS Atypical Manic Disorder Atypical Depressive Disorder

Page 19

296.20 296.21 296.22 296.23 296.24 296.25 296.26 296.30 296.31 296.32 296.33 296.34 296.35 296.36 296.40 296.40 296.41 296.42 296.43 296.44 296.45 296.46 296.50 296.51 296.52 296.53 296.54 296.55 296.56 296.60 296.61 296.62 296.63 296.64 296.65 296.66 296.7 296.80

DSM-IV 296.89 296.90

ICD-9-CM 296.89 296.90 296.99 297.0 297.1 297.2 297.3 297.8 297.9 298.0 298.1 298.2 298.3 298.4 298.8 298.9 300.00 300.01 300.02 300.09 300.10 300.11 300.12 300.13 300.14 300.15 300.16 300.19 300.19 300.19 300.20 300.21 300.22 300.23 300.29 300.3 300.4 300.5 300.6 300.7 300.81 300.82 300.9 301.0 301.10 301.11 301.12 301.13 301.20 301.21 301.22

DESCRIPTION Bipolar II Disorder Mood Disorder NOS/Unspecified Affective Psychosis Other Specified Affective Psychoses Paranoid State, Simple Delusional Disorder/Paranoia Paraphrenia Shared Psychotic Disorder/Shared Paranoid Disorder Other Specified Paranoid States Unspecified Paranoid State Depressive Type Psychosis Excitative Type Psychosis Reactive Confusion Acute Paranoid Reaction Psychogenic Paranoid Psychosis Brief Psychotic Disorder/ Other and Unspecified Reactive Psychosis Psychotic Disorder NOS Anxiety Disorder NOS Panic Disorder Without Agoraphobia Generalized Anxiety Disorder Anxiety States, Other Hysteria, Unspecified Conversion Disorder Dissociative Amnesia/Psychogenic Amnesia Dissociative Fugue/Psychogenic Fugue Dissociative Identity Disorder/Multiple Personality Dissociative Disorder NOS Factitious Disorder With Predominantly Psychological Signs and Symptoms Factitious Disorder NOS/Other and Unspecified Factitious Illness Factitious Disorder With Combined Psychological and Physical Signs and Symptoms/Other and Unspecified Factitious Illness Factitious Disorder With Predominantly Physical Signs and Symptoms/Other and Unspecified Factitious Illness Phobia, Unspecified Panic Disorders with Agoraphobia Agoraphobia Without History of Panic Disorder Social Phobia Specific Phobia/Other Isolated or Simple Phobias Obsessive-Compulsive Disorder Dysthymic Disorder/Neurotic Depression Neurasthenia Depersonalization Disorder Body Dysmorphic Disorder/Hypochondriasis Somatization Disorder Somatoform Disorder NOS, Undifferentiated Somatoform Disorder Unspecified Mental Disorder (non-psychotic)/Unspecified Neurotic Disorder Paranoid Personality Disorder Affective Personality Disorder, Unspecified Chronic Hypomanic Personality Disorder Chronic Depressive Personality Disorder Cyclothymic Disorder Schizoid Personality Disorder Introverted Personality Schizotypal Personality Disorder

Page 20

297.1 297.3

298.8 298.9 300.00 300.01 300.02

300.11 300.12 300.13 300.14 300.15 300.16 300.19 300.19 300.19

300.21 300.22 300.23 300.29 300.3 300.4 300.6 300.7 300.81 300.82 300.9 301.0

301.13 301.20 301.22

DSM-IV 301.4 301.50

ICD-9-CM 301.3 301.4 301.50 301.51 301.59 301.6 301.7 301.81 301.82 301.83 301.84 301.89 301.9 302.1 302.2 302.3 302.4 302.50 302.51 302.52 302.53 302.6 302.6 302.70 302.71 302.72 302.72 302.73 302.74 302.75 302.76 302.79 302.81 302.82 302.83 302.84 302.85 302.89 302.9 302.9 306.51 307.1 307.20 307.21 307.22 307.23 307.3 307.40 307.42 307.42

DESCRIPTION Explosive Personality Disorder Obsessive-Complusive Personality Disorder Histrionic Personality Disorder Chronic Factitious Illness With Physical Symptoms Other Histrionic Personality Disorder Dependent Personality Disorder Antisocial Personality Disorder Narcissistic Personality Disorder Avoidant Personality Disorder Borderline Personality Disorder Passive-aggressive Personality Personality Disorder, Other Personality Disorder NOS Zoophilia Pedophilia Transvestic Fetishism Exhibitionism Trans-sexualism, With Unspecified Sexual History Trans-sexualism, With Asexual History Trans-sexualism, With Homosexual History Trans-sexualism, With Heterosexual History Gender Identity Disorder NOS/Disorders of Psychosexual Identity Gender Identity Disorder in Children/Disorders of Psychosexual Identity Sexual Dysfunction NOS Hypoactive Sexual Desire Disorder/Psychosexual Dysfunction With Inhibited Sexual Desire Female Sexual Arousal Disorder/Psychosexual Dysfunction With Inhibited Sexual Excitement Male Erectile Disorder/Psychosexual Dysfunction With Inhibited Sexual Excitement Female Orgasmic Disorder/Psychosexual Dysfunction With Inhibited Female Orgasm Male Orgasmic Disorder/Psychosexual Dysfunction With Inhibited Male Orgasm Premature Ejaculation/Psychosexual Dysfunction with Premature Ejaculation Dyspareunia [Not Due to a General Medical Condition]/Psychosexual Disorder With Functional Dysparenunia Sexual Aversion Disorder/Psychosexual Dysfunction With Other Specified Psychosexual Dysfunctions Fetishism Voyeurism Sexual Masochism Sexual Sadism Gender Identity Disorder in Adolescents or Adults Frotteurism/Other Specified Psychosexual Disorder Sexual Disorder NOS/Unspecified Psychosexual Disorder Paraphilia NOS/Unspecified Psychosexual Disorder Vaginismus [Not Due to a General Medical Condition]/Psychogenic Vaginismus Anorexia Nervosa Tic Disorder NOS Transient Tic Disorder/Transiant Tic Disorder of Childhood Chronic Motor or Vocal Tic Disorder Tourette's Disorder Stereotypic Movement Disorder/Stereotyped Repetitive Movements Dyssomnia NOS/Parasomnia NOS Insomnia Related To..[Indicate the Axis I or II Disorder]/Persistent Disorder of Initiating or Maintaining Sleep Primary Insomnia/Persistent Disorder of Initiating or Maintaining Sleep

Page 21

301.6 301.7 301.81 301.82 301.83

301.9 302.2 302.3 302.4

302.6 302.6 302.70 302.71 302.72 302.72 302.73 302.74 302.75 302.76 302.79 302.81 302.82 302.83 302.84 302.85 302.89 302.9 302.9 306.51 307.1 307.20 307.21 307.22 307.23 307.3 307.42 307.42

DSM-IV 307.44 307.44 307.46 307.46 307.47 307.47 307.47 307.50 307.51 307.52 307.53 307.59 307.6 307.7

ICD-9-CM 307.44 307.44 307.46 307.46 307.47 307.47 307.47 307.50 307.51 307.52 307.53 307.54 307.59 307.6 307.7 308.0 308.1 308.2 308.3 308.4 308.9 309.0 309.1 309.21 309.24 309.28 309.29 309.3 309.4 309.81 309.9 310.1 311 312.00 312.01 312.02 312.03 312.10 312.11 312.12 312.13 312.20 312.21 312.22 312.23 312.30 312.31 312.32 312.33 312.34 312.35

DESCRIPTION Primary Hypersomnia/Persistent Disorder of Initiating or Maintaining Wakefulness Hypersomnia Related to..[Indicate the Axis I or II Disorder]/Persistent Disorder of Initiating or Maintaining Wakefulness Sleep Terror Disorder/Somnambulism or Night Terrors Sleepwalking Disorder/Somnambulism or Night Terrors Dyssomnia NOS/Other Dysfunctions of Sleep Stages or Arousal from Sleep Nightmare Disorder/Other Dysfunctions of Sleep Stages or Arousal from Sleep Parasomnia NOS/Other Dysfunctions of Sleep Stages or Arousal from Sleep Eating Disorder NOS Bulimia Nervosa Pica Rumination Disorder/Psychogenic Rumination Psychogenic Vomiting Feeding Disorder of Infancy or Early Childhood Enuresis (Not Due to General Medical Condition) Encopresis, Without Constipation and Overflow Incontinence Acute Reaction to Stress, Predominant Disturbance of Emotions Acute Reaction to Stress, Predominant Disturbance of Consciousness Acute Reaction to Stress, Predominant Psychomotor Dysfunction Acute Stress Disorder/Other Acute Reactions to Stress Mixed Disorders as Reaction to Stress Acute Reaction to Stress, Unspecified Adjustment Disorder With Depressed Mood/Brief Depressive Reaction Prolonged Depressive Reaction Separation Anxiety Disorder Adjustment Disorder With Anxiety/Adjustment Reaction with Anxious Mood Adjustment Disorder With Mixed Anxiety and Depressed Mood Adjustment Reaction With Predominant Disturbance of Other Emotions, Other Adjustment Disorder with Disturbance of Conduct Adjustment Disorder with Mixed Disturbance of Emotions and Conduct Posttraumatic Stress Disorder Adjustment Disorder Unspecified Personality Change Due to..(Indicate the General Medical Condition)/Organic Personality Syndrome Depressive Disorder NOS Undersocialized Conduct Disorder, Aggressive Type Undersocialized Conduct Disorder, Aggressive Type, Mild Undersocialized Conduct Disorder, Aggressive Type, Moderate Undersocialized Conduct Disorder, Aggressive Type, Severe Undersocialized Conduct Disorder, Unaggressive Type Undersocialized Conduct Disorder, Unaggressive Type, Mild Undersocialized Conduct Disorder, Unaggressive Type, Moderate Undersocialized Conduct Disorder, Unaggressive Type, Severe Socialized Conduct Disorder Socialized Conduct Disorder, Mild Socialized Conduct Disorder, Moderate Socialized Conduct Disorder, Severe Impulse-Control Disorder NOS Pathological Gambling Kleptomania Pyromania Intermittent Explosive Disorder Isolated Explosive Disorder

Page 22

308.3

309.0 309.21 309.24 309.28 309.3 309.4 309.81 309.9 310.1 311

312.30 312.31 312.32 312.33 312.34

DSM-IV 312.39 312.81 312.82 312.89 312.9

ICD-9-CM 312.39 312.4 312.81 312.82 312.89 312.9 313.0 313.21 313.22 313.23 313.81 313.82 313.89 313.9 314.00 314.01 314.01 314.1 314.2 314.8 314.9 316 V71.0

DESCRIPTION Trichotillomania/Disorder of Impulse Control, Other Mixed Disturbance of Conduct and Emotions Conduct Disorder, Childhood-Onset Type Conduct Disorder, Adolescent-Onset Type Conduct Disorder, Unspecified Onset Disruptive Behavior Disorder NOS/Unspecified Disturbance of Conduct Overanxious Disorder Shyness Disorder of Childhood Introverted Disorder of Childhood Selective Mutism/Elective Mutism Oppositional Defiant Disorder Identity Problem/Identity Disorder Reactive Attachment Disorder of Infancy or Early Childhood/Other or Mixed Emotional Disturbances of Childhood or Adolescence, Other Disorder of Infancy, Childhood or Adolescence NOS/Unspecified Emotional Disturbance of Childhood or Adolescence Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type Attention-Deficit/Hyperactivity Disorder, Combined Type Hyperkinesis With Developmental Delay Hyperkinetic Conduct Disorder Other Specified Manifestations of Hyperkinetic Syndrome Attention-Deficit/Hyperactivity Disorder NOS/Unspecified Hyperkinetic Syndrome [Specified Psychological Factor] Affecting..[Ind. the Gen. Med. Cond.]/Psychic Factors Associated with Disease Classified Elsewhere Observation for Suspected Mental Condition

313.23 313.81 313.82 313.89 313.9 314.00 314.01 314.01

314.9 316

Page 23

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