Table of Contents
Common Mental Health Diagnosis Codes Used When Billing Insurance
Common Mental Health Diagnosis Codes
- Major Depressive Disorder (MDD) – F32.x for a single episode, F33.x for recurrent episodes.
- Generalized Anxiety Disorder (GAD) – F41.1
- Panic Disorder – F41.0
- Post-Traumatic Stress Disorder (PTSD) – F43.10
- Obsessive-Compulsive Disorder (OCD) – F42
- Bipolar Disorder
- Bipolar I Disorder – F31.x
- Bipolar II Disorder – F31.81
- Schizophrenia – F20.9
- Social Anxiety Disorder (Social Phobia) – F40.10
- Specific Phobia – F40.2
- Attention-Deficit/Hyperactivity Disorder (ADHD)
- Predominantly Inattentive Presentation – F90.0
- Predominantly Hyperactive-Impulsive Presentation – F90.1
- Combined Presentation – F90.2
- Autism Spectrum Disorder (ASD) – F84.0
- Anorexia Nervosa – F50.0
- Bulimia Nervosa – F50.2
- Substance Use Disorders – Varies by substance, e.g., Alcohol Use Disorder – F10.10 (mild), F10.20 (moderate), F10.20 (severe)
- Adjustment Disorders – F43.20
- Personality Disorders
- Borderline Personality Disorder – F60.3
- Antisocial Personality Disorder – F60.2
- Dissociative Identity Disorder (DID) – F44.81
- Somatic Symptom Disorder – F45.1
- Persistent Depressive Disorder (Dysthymia) – F34.1
- Insomnia Disorder – F51.01
- Hypersomnolence Disorder – G47.10
- Body Dysmorphic Disorder – F45.22
- Delirium – F05
- Neurodevelopmental Disorders – Various codes, e.g., Intellectual Disability – F70-F79
- Alcohol-Induced Major Neurocognitive Disorder (Dementia) – F10.97
When Insurance Falls Short and Denies Your Claim
While understanding these diagnostic codes can help in navigating insurance coverage, it’s important to acknowledge that not all treatments or services might be covered under every health plan.
At times, insurance carriers may deny claims for various reasons, including disputes over the necessity or appropriateness of treatment based on the diagnosis code.
Providers strive to ensure accurate coding and billing to minimize such issues, but ultimately, they are not responsible for insurance denials. In cases where insurance doesn’t cover certain treatments or if there’s a gap in coverage, patients have the option to explore financing solutions like CareCredit.
CareCredit is a healthcare credit card designed specifically for health, wellness, and personal care expenses, allowing members to manage out-of-pocket costs more effectively. It’s crucial for individuals to understand that while providers and billing staff work diligently to secure coverage, the responsibility for denied claims or uncovered expenses lies with the patient. Utilizing financing options like CareCredit can provide flexibility in managing healthcare costs, ensuring that necessary care is accessible regardless of insurance limitations.