ICD-10 for Billing versus DSM-5 for Diagnosing: A Commentary on Litigation and Legislation (pp. 85-106)
Authors: Freddy A. Paniagua
Abstract: The International Classification of Diseases (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders-DSM-5 are the two classification systems for mental disorders often used by mental health practitioners. In the ICD-10, Chapter 5 deals with mental disorders. This chapter is available in different versions for different purposes, and one of these versions is the ICD-10 Clinical Descriptions and Diagnostic Guidelines (ICD/CDDG-10) intended for mental health practitioners wanting to diagnose mental disorders using the ICD-10 in World Health Organization countries. A variant of the ICD-10 (ICD-10-CM) is required by physicians and mental health practitioners wanting to be reimbursed for clinical services conducted in the United States. Nordal (2014) suggests that mental health practitioners should use all variants of the ICD-10 coding system for billing purposes and the DSM-5 for diagnosing mental disorders. A review of a sample of mental disorders with emphasis on children and adolescents discussed in the ICD/CDDG-10 and the ICD-10-CM confirms Nordalís suggestion, in that these variants of the ICD lacks diagnostic precision across such disorders, relative to the DMS-5 which provides specific diagnostic criteria leading to the appropriate diagnosis of selected mental discussed in this paper. Litigation and legislation issues with the use of the ICD-10 are also discussed.