Depression is a common problem encountered in primary care practice. According to a study, one in every 15 adults (almost 7%) of the US population is affected by depression each year. While depression is found to occur in any phase of life, normally it first starts to appear during the late teens. Some studies indicate that women are more likely to experience depression than men and there may be as much as one-third of women in the US who go through a bout of depression in their lifetime.
When it comes to managing and providing care to patients with depression, there are many barriers that health care physicians face. The ambiguity surrounding the financial reimbursement process is the foremost factor, as well as a lack of knowledge in the coding and documentation when it comes to the treatment of depression. This article describes the depression ICD 10 corresponding codes, the guidelines set forth, and the history for the coding to date. Let’s dig in!
What is depression?
Depression is described as a disorder that affects mood. Feelings such as loss, sadness, and anger are classified under depression that is found to interfere with a person’s everyday life resulting in lower productivity and lost time.
Depression is found to affect relationships and influence chronic health conditions such as heart conditions, asthma, obesity, and diabetes. Without proper attention and treatment, depression can get worse and morph into a serious medical condition. With proper treatment, improvements can be seen in just a few weeks.
It is important to note that feeling down at times is normal and part of life, and is not always a case of depression. But if you are feeling hopeless and sad on a regular basis, it could be depression, and would be a good idea to consult your healthcare provider.
History of Depression ICD-10
Back in the 1960s, the Mental Health Program under the WHO started a program that aimed to improve the diagnosis and documentation of mental disorders. Representatives from different disciples and schools of thought in psychiatry presented their extensive research and presented proposals for the task. Finally, the accumulated work was incorporated in the Eight Revisions of the International Classification of Diseases (ICD-10).
The next decade saw an increase in interest in psychiatric classification globally. Expansion of international contacts, the undertaking of several international collaborative studies, and the availability of new treatments all contributed to this trend. Several national psychiatric bodies encouraged the development of specific criteria for classification in order to improve diagnostic reliability.
In the late 70s, the World Health Organization teamed up with the Alcohol, Drug Abuse, and Mental Health Administration in the USA to further streamline the classification and diagnosis of mental disorders, including depression. Then followed a series of workshops that brought together scientists and researchers from different countries, with the purpose of paving the way for future work.
A mutually beneficial relationship evolved between these projects and the work on definitions of mental and behavioral disorders in the Tenth Revision of the International Classification of Diseases and Related Health Problems -3- (ICD-10) (9). Converting diagnostic criteria into diagnostic algorithms incorporated in the assessment instruments was useful in uncovering inconsistencies, ambiguities, and overlap and allowing their removal. The work on refining the ICD-10 also helped to shape the assessment instruments. The final result was a clear set of criteria for ICD-10 and assessment instruments which can produce data necessary for the classification of disorders according to the criteria included in Chapter V(F) of ICD-10.
ICD-10 code set
ICD-10 (short for International Classification of Diseases, tenth edition) is a clinical documentation and cataloging system owned by the World Health organization which consists of thousands of codes, where each code represents critical information about the different diseases, findings, causes of injuries, symptoms, possible treatments, and epidemiology, playing a vital role in enabling advancements in clinical treatment and medication.
Under the Health Insurance Portability and Accountability Act (HIPAA), it is required by all healthcare providers and physicians to apply the ICD-10 codes in their practices, replacing the previous ICD-9 code set.
ICD serves as a foundation to identify clinical trends and statistics globally. Diseases, injuries, disorders, and all health conditions are listed comprehensively and organized into standard groupings allowing health care providers from around the world to compare and share information using the ICD codes.
Depression ICD-10 Codes and Guidelines
F32 is the corresponding depression ICD-10 code which is further divided into mild, moderate, and severe episodes. A physician can identify the following symptoms and use them to classify the patient in either of the codes for the respected episodes:
– Capacity for enjoyment, concentration, and interest is reduced
-Disturbed sleep and appetite
– Marked tiredness even with minimum efforts
– Reduced self-confidence and self-esteem
– Loss of pleasurable feelings
– Loss of libido as well as weight
Mild depression ICD-10 – F32.0
At least two or three symptoms described above are present in mild episodes of depression, but the person can continue with most social activities.
Moderate depression ICD-10 – F32.1
Normally more than four symptoms are present and the patient finds it difficult to perform in everyday activities.
Severe depression ICD-10- F32.3
Characterized by hallucinations, psychomotor retardation, stupors, and delusions so severe that one is not able to perform any everyday activity. The condition may become life-threatening due to starvation, dehydration, and even suicide.
Depression ICD-10 unspecified – F32.9
Coding for the diagnosis and treatment of depression is fraught with peril. Some patients may not like the diagnosis and some payers may not cover the service. However, if those obstacles can be overcome, diagnosis and treatment of depression can pay as well as the diagnosis and treatment of other conditions commonly seen in family medicine.