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• DSM-IV-TR
• DSM-ICD Coding Crosswalk
• Other Coding Discrepancies

Other Coding Discrepancies

There are a number of examples where the AHIMA crosswalk indicates different Internationcal Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) codes from what we have in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR).   Differences include: Bipolar Not Otherwise Specified (NOS) (DSM-IV-TR: 296.89, ICD-9-CM 296.7), Delusional Disorder (DSM-IV-TR 297.1, ICD-9-CM: 297.9); Attention-deficit/hyperactivity NOS (DSM-IV-TR 314.9, ICD-9-CM: 314.01).  These discrepancies are due to the way the disorders are listed in the ICD-9-CM index.

In other cases, two different ICD-9-CM codes are offered based on distinctions among the ICD-9-CM categories which are not recognized in the DSM-IV: (292.81 is used for both intoxication delirium and withdrawal delirium in DSM-IV-TR, whereas the cross-walk suggests 292.81 for intoxication delirium and 292.0 for withdrawal delirium); (303.00 is used for Alcohol Intoxication in DSM-IV; in ICD-9-CM, the code is "303.0x for Alcohol Intoxication with Alcoholism" or "305.0x for Alcohol Intoxication without alcoholism); (307.42 is for primary insomnia in DSM-IV-TR, while in ICD-9-CM the code is 307.41 for "transient" insomnia and 307.42 for "persistent insomnia")(307.44 is for primary hypersomnia in DSM-IV; in ICD-9-CM the code is 307.43 for "transient hypersomnia" and 307.44 for "persistent hypersomnia"  

In some cases, particularly in the sexual dysfunction section, the ICD-9-CM crosswalk is simply incorrect, suggesting that 302.7 and 302.8 be assigned for sexual dysfunctions due to general medical conditions when it is clear from the ICD-9-CM tabular that these condition would be excluded (i.e., 302.7 and 302.8 are for ‘non-organic” sexual dysfunctions).  This "error" actually reflects problems in the ICD-9-CM index, which appears to incorrectly lead coders to the wrong code (at least insofar as the AHIMA person who did the cross-walk interprets the index entries).  These errors apply to the DSM-IV-TR codes 608.89 and 625.8.