LCD/NCD Portal

L28973

 

PSYCHIATRIC PARTIAL HOSPITALIZATION PROGRAM

 

01/01/2013

 

Indications and Limitations of Coverage and/or Medical Necessity

• Partial hospitalization programs (PHPs) are structured to provide intensive psychiatric care through active treatment that utilizes a combination of the clinically recognized items and services described in §1861(ff) of the Social Security Act (the Act).

• The treatment program of a PHP closely resembles that of a highly structured, short-term hospital inpatient program. It is treatment at a level more intense than outpatient day treatment or psychosocial rehabilitation.

• Programs providing primarily social, recreational, or diversionary activities are not considered partial hospitalization.

Program Criteria

• The PHPs work best as part of a community continuum of mental health services which range from the most restrictive inpatient hospital setting to less restrictive outpatient care and support.

o Program objectives should focus on ensuring important community ties and closely resemble the real-life experiences of the patients served.

o PHPs may be covered under Medicare when they are provided by a hospital outpatient department or a Medicare-certified CMHC.

• Partial hospitalization is active treatment that incorporates an individualized treatment plan which describes a coordination of services wrapped around the particular needs of the patient, and includes a multidisciplinary team approach to patient care under the direction of a physician.

o The program reflects a high degree of structure and scheduling.

o According to current practice guidelines, the treatment goals should be measurable, functional, time-framed, medically necessary, and directly related to the reason for admission.

• A program comprised primarily of diversionary activity, social, or recreational therapy does not constitute a PHP.

o Psychosocial programs which provide only a structured environment, socialization, and/or vocational rehabilitation are not covered by Medicare.

o A program that only monitors the management of medication for patients, whose psychiatric condition is otherwise stable, is not the combination, structure, and intensity of services which make up active treatment in a PHP.

• The following are facilities eligible for reimbursement for partial hospitalization services and the associated physician supervision requirements of each:

o Outpatient hospital

 Partial hospitalization services rendered within a hospital outpatient department are considered “incident to” a physician’s (MD/DO) services and require physician supervision.

 The physician supervision requirement is presumed to be met when services are performed on hospital premises (i.e., certified as part of the hospital).

 If a hospital outpatient department operates a PHP offsite, the services must be rendered under the direct personal supervision of a physician (MD/DO).

 Direct supervision means that the physician must be physically present in the same office suite and immediately available to provide assistance and direction throughout the time the employee is performing the service.

o Community mental health center (CMHC)

 The CMHC must meet applicable certification or licensure requirements of the state in which they operate, and additionally be certified by Medicare.

 A CMHC is a Medicare provider of services only with respect to the furnishing of partial hospitalization services under Section 1866(e) (2) of the Social Security Act.

 Health Care Finance Administration definition of a CMHC is based on Section 1916 (c) (4) of the Public Health Service (PHS) Act.

 The PHS definition of a CMHC is cross-referenced in Section 1861 (ff) of the Act.

• The program must be prepared to appropriately treat the co-morbid substance abuse disorder when it exists (dual diagnosis patients).

o Dual diagnosed individuals suffer from concomitant mental illness and chemical dependency.

o Sobriety, as an initial clinical goal, is essential for further differential diagnosis and clinical decisions about appropriate treatment.

o It is not generally expected that a patient who is actively using a chemical substance be admitted to or engaged in a partial hospitalization program, as a patient under the influence of a chemical substance would not be capable of actively participating in his/her psychiatric treatment program.

o A physician must provide supervision and evaluation of the patient’s treatment and the extent to which the therapeutic goals are being met.

Patient Eligibility Criteria

• Benefit Category

o Patients must meet benefit requirements for receiving the partial hospitalization services as defined in §1861(ff) and §1835(a) (2) (F) of the Act.

 Patients admitted to a PHP must be under the care of a physician who certifies the need for partial hospitalization and require minimum of 20 hours per week of therapeutic services, as evidenced by their plan of care.

 The patients also require a comprehensive, structured, multimodal treatment requiring medical supervision and coordination, provided under an individualized plan of care, because of a mental disorder which severely interferes with multiple areas of daily life, including social, vocational, and/or educational functioning.

  Such dysfunction generally is of an acute nature.

 In addition, PHP patients must be able to cognitively and emotionally participate in the active treatment process, and be capable of tolerating the intensity of a PHP program.

o Patients meeting benefit category requirements for Medicare coverage of a PHP comprise two groups:

 Those patients who are discharged from an inpatient hospital treatment program and the PHP are in lieu of continued inpatient treatment.

 Those patients who, in the absence of partial hospitalization, would be at reasonable risk of requiring inpatient hospitalization.

 Where partial hospitalization is used to shorten an inpatient stay and transition the patient to a less intense level of care, there must be evidence of the need for the acute, intense, structured combination of services provided by a PHP.

 Recertification must address the continuing serious nature of the patient’s psychiatric condition requiring active treatment in a PHP.

o Prior to receiving partial hospitalization services, it would be expected that patients have failed attempts at outpatient psychotherapy.

 Clear, concise documentation of these attempts including date of last appointment, type of treatment provided or attempted shall be a part of the initial assessment.

o Discharge planning from PHP may reflect the types of best practices recognized by professional and advocacy organizations that ensure coordination of needed services and follow-up care.

 These activities include linkages with community resources, supports, and providers in order to promote a patient’s return to a higher level of functioning in the least restrictive environment.

o Partial hospitalization services that make up a program of active treatment must be vigorous and proactive (as evidenced in the individual treatment plan and progress notes) as opposed to passive and custodial.

 It is not enough that a patient qualify under the benefit category requirements §1835(a) (2) (F) unless he/she also has the need for the active treatment provided by the program of services defined in §1861(ff).

 It is the need for intensive, active treatment of his/her condition to maintain a functional level and to prevent relapse or hospitalization, which qualifies the patient to receive the services identified in §1861(ff).

 

• Reasonable and Necessary Services

o This program of services provides for the diagnosis and active, intensive treatment of the individual’s serious psychiatric condition and, in combination, is reasonably expected to improve or maintain the individual’s condition and functional level and prevent relapse or hospitalization.

 A particular individual covered service (described above) as intervention, expected to maintain or improve the individual’s condition and prevent relapse, may also be included within the plan of care, but the overall intent of the partial program admission is to treat the serious presenting psychiatric symptoms.

 Continued treatment in order to maintain a stable psychiatric condition or functional level requires evidence that less intensive treatment options (e.g., intensive outpatient, psychosocial, day treatment, and/or other community supports) cannot provide the level of support necessary to maintain the patient and to prevent hospitalization.

o Patients admitted to a PHP do not require 24 hour per day supervision as provided in an inpatient setting, and must have an adequate support system to sustain/maintain themselves outside the PHP and must not be an imminent danger to themselves or others.

 Patients admitted to a PHP generally have an acute onset or decompensation of a covered Axis I mental disorder, as defined by the current edition of the Diagnostic and Statistical Manual published by the American Psychiatric Association or listed in Chapter 5, of the most current edition of the International Classification of Diseases (ICD), which severely interferes with multiple areas of daily life.

 The degree of impairment will be severe enough to require a multidisciplinary intensive, structured program, but not so limiting that patients cannot benefit from participating in an active treatment program.

 It is the need, as certified by the treating physician, for the intensive, structured combination of services provided by the program that constitute active treatment, that are necessary to appropriately treat the patient’s presenting psychiatric condition.

o For patients who do not meet this degree of severity of illness, and for whom partial hospitalization services are not necessary for the treatment of a psychiatric condition, professional services billed to Medicare Part B (e.g., services of psychiatrists and psychologists) may be medically necessary, even though partial hospitalization services are not.

o The patient must require comprehensive, multimodal treatment requiring medical supervision and coordination because of a mental disorder, which severely interferes with multiple areas of daily life including social, vocational, and/or educational functioning.

 Such dysfunction must be an acute illness or exacerbation of a chronic illness (acute in nature).

o Patients with a diagnosis of psychosis must be aggressively treated with psycho-pharmacological agents to reduce symptoms that may impede benefit from the services provided by a PHP program.

 Partial stabilization allowing the patient to participate with insight-oriented therapy should be clearly documented.

 For example, a patient may interact in a one to one session rather than in a group therapy setting initially.

 It would be expected patient progression would be toward the group settings.

o Patients in PHP may be discharged by either stepping up to an inpatient level of care which would be required for patients needing 24-hour supervision, or stepping down to a less intensive level of outpatient care when the patient’s clinical condition improves or stabilizes and he/she no longer requires structured, intensive, multimodal treatment.

 

• Reasons for Denial

 

o Benefit category denials made under §1861(ff) or §1835(a) (2) (F) are not appealable by the provider and the limitation on liability provision does not apply (HCFA Ruling 97-1).

 Examples of benefit category based in §1861(ff) or §1835(a)(2)(F) of the Act, for partial hospitalization services generally include the following:

• Day care programs, which provide primarily social, recreational, or diversionary activities, custodial or respite care.

• Programs attempting to maintain psychiatric wellness, where there is no risk of relapse or hospitalization, e.g., day care programs for the chronically mentally ill.

• Patients who are otherwise psychiatrically stable or require medication management only.

o Coverage denials made under §1861(ff) of the Act are not appealable by the provider and the Limitation on Liability provision does not apply (HCFA Ruling 97-1).

 The following services are excluded from the scope of partial hospitalization services defined in §1861(ff) of the Social Security Act:

• Services to hospital inpatients.

• Meals, self-administered medications, transportation.

• Vocational training.

o Reasonable and necessary denials based on §1862(a)(1)(A) are appealable and the Limitation on Liability provision does apply.

 The following examples represent reasonable and necessary denials for partial hospitalization services and coverage is excluded under §1862(a)(1)(A) of the Social Security Act:

• Patients who cannot, or refuse, to participate (due to their behavioral or cognitive status) with active treatment of their mental disorder (except for a brief admission necessary for diagnostic purposes), or who cannot tolerate the intensity of a PHP.

• Treatment of chronic conditions without acute exacerbation of symptoms that place the individual at risk of relapse or hospitalization.

o The following discussion illustrates the application of the above guidelines to the more common modalities and procedures used in the treatment of psychiatric patients and some factors that are considered in determining whether the coverage criteria are met.

 

• Covered Services

o Services generally covered for the treatment of psychiatric patients are:

 Individual and group therapy with physicians, psychologists, or other mental health professionals authorized by the State.

 Occupational therapy services are covered if they require the skills of a qualified occupational therapist and be performed by or under the supervision of a qualified occupational therapist or by an occupational therapy assistant.

 Services of social workers, trained psychiatric nurses, and other staff trained to work with psychiatric patients.

 Drugs and biologicals furnished to outpatients for therapeutic purposes, but only if they are of a type which cannot be self-administered.

 Activity therapies but only those that are individualized and essential for the treatment of the patient's condition.

• The treatment plan must clearly justify the need for each particular therapy utilized and explain how it fits into the patient's treatment.

 Family counseling services.

• Counseling services with members of the household are covered only where the primary purpose of such counseling is the treatment of the patient's condition.

 Patient education programs, but only where the educational activities are closely related to the care and treatment of the patient.

 Diagnostic services for the purpose of diagnosing those individuals for whom an extended or direct observation is necessary to determine functioning and interactions, to identify problem areas, and to formulate a treatment plan.

 

• Noncovered Services

o The following are generally NOT covered except as indicated:

 Meals and transportation.

• Activity therapies, group activities or other services and programs which are primarily recreational or diversional in nature.

• Outpatient psychiatric day treatment programs that consist entirely of activity therapies are not covered.

 “Geriatric day care" programs are available in both medical and nonmedical settings.

• They provide social and recreational activities to older individuals who need some supervision during the day while other family members are away from home.

• Such programs are not covered since they are NOT considered reasonable and necessary for a diagnosed psychiatric disorder, nor do such programs routinely have physician involvement.

 Psychosocial programs.

• These are generally community support groups in nonmedical settings for chronically mentally ill persons for the purpose of social interaction.

• Outpatient programs may include some psychosocial components; and to the extent these components are not primarily for social or recreational purposes, they are covered.

• However, if an individual's outpatient hospital program consists entirely of psychosocial activities, it is not covered.

 Vocational training.

• While occupational therapy may include vocational and prevocational assessment and training, when the services are related solely to specific employment opportunities, work skills or work settings, they are not covered.

• CPT code 90849 (Multiple family group psychotherapy) would not be considered treatment directly related to the patient’s care and therefore would not be considered medically necessary.

 

• Frequency and Duration of Services

o There are no specific limits on the length of time that services may be covered.

 There are many factors that affect the outcome of treatment; among them are the nature of the illness, prior history, the goals of treatment, and the patient's response.

 As long as the evidence shows that the patient continues to show improvement in accordance with his/her individualized treatment plan, and the frequency of services is within accepted norms of medical practice, coverage may be continued.

o If a patient reaches a point in his/her treatment where further improvement does not appear to be indicated, evaluate the case in terms of the criteria to determine whether with continued treatment there is a reasonable expectation of improvement.

o When participation in the therapeutic program produces no further functional improvement or movement towards the initial or revised goals documented in the treatment plan, the patient is deemed to have reached maximal improvement at which point further participation in the program is no longer subject to coverage.

Coding Information

 

Bill Type Codes

• Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service.

• Absence of a Bill Type does not guarantee that the policy does not apply to that Bill Type.

• Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the policy should be assumed to apply equally to all claims.

 

13x Hospital Outpatient

76x Clinic - Community Mental Health Center

85x Critical Access Hospital

 

Revenue Codes

• Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service.

• In most instances Revenue Codes are purely advisory; unless specified in the policy services reported under other Revenue Codes are equally subject to this coverage determination.

• Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the policy should be assumed to apply equally to all Revenue Codes.

 

 

0250 Pharmacy - General Classification

0430 Occupational Therapy - General Classification

0431 Occupational Therapy - Visit

0432 Occupational Therapy - Hourly

0433 Occupational Therapy - Group

0434 Occupational Therapy - Evaluation or Reevaluation

0439 Occupational Therapy - Other Occupational Therapy

0900 Behavioral Health Treatment/Services - General Classification

0904 Behavioral Health Treatment/Services - Activity Therapy

0914 Behavioral Health Treatment/Services - Individual Therapy

0915 Behavioral Health Treatment/Services - Group Therapy

0916 Behavioral Health Treatment/Services - Family Therapy

0918 Behavioral Health Treatment/Services - Testing

0942 Other Therapeutic Services - Education/Training

 

 

CPT/HCPCS Codes

 

 

There are no specific CPT or HCPCS codes for partial hospitalization “programs”. However, outpatient hospitals are required to report the following appropriate CPT/HCPCS codes for the individual or specific partial hospitalization services provided. Effective for dates of services on or after June 5, 2000 Community Mental Health Centers will also be required to utilize the same HCPCS codes for reporting partial hospitalization services.

 

 

There are CPT/HCPCS codes on this list that may not be reimbursable through Medicare due to existing National or Local Coverage Determinations. Please refer to the applicable Medicare manuals and Local Coverage Determinations for coverage criteria information regarding each service.

 

90785 INTERACTIVE COMPLEXITY (LIST SEPARATELY IN ADDITION TO THE CODE FOR PRIMARY PROCEDURE)

90791 PSYCHIATRIC DIAGNOSTIC EVALUATION

90792 PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES

90832 PSYCHOTHERAPY, 30 MINUTES WITH PATIENT AND/OR FAMILY MEMBER

90833 PSYCHOTHERAPY, 30 MINUTES WITH PATIENT AND/OR FAMILY MEMBER WHEN PERFORMED WITH AN EVALUATION AND MANAGEMENT SERVICE (LIST SEPARATELY IN ADDITION TO THE CODE FOR PRIMARY PROCEDURE)

90834 PSYCHOTHERAPY, 45 MINUTES WITH PATIENT AND/OR FAMILY MEMBER

90836 PSYCHOTHERAPY, 45 MINUTES WITH PATIENT AND/OR FAMILY MEMBER WHEN PERFORMED WITH AN EVALUATION AND MANAGEMENT SERVICE (LIST SEPARATELY IN ADDITION TO THE CODE FOR PRIMARY PROCEDURE)

90837 PSYCHOTHERAPY, 60 MINUTES WITH PATIENT AND/OR FAMILY MEMBER

90838 PSYCHOTHERAPY, 60 MINUTES WITH PATIENT AND/OR FAMILY MEMBER WHEN PERFORMED WITH AN EVALUATION AND MANAGEMENT SERVICE (LIST SEPARATELY IN ADDITION TO THE CODE FOR PRIMARY PROCEDURE)

90846 FAMILY PSYCHOTHERAPY (WITHOUT THE PATIENT PRESENT)

90847 FAMILY PSYCHOTHERAPY (CONJOINT PSYCHOTHERAPY) (WITH PATIENT PRESENT)

90875 INDIVIDUAL PSYCHOPHYSIOLOGICAL THERAPY INCORPORATING BIOFEEDBACK TRAINING BY ANY MODALITY (FACE-TO-FACE WITH THE PATIENT), WITH PSYCHOTHERAPY (EG, INSIGHT ORIENTED, BEHAVIOR MODIFYING OR SUPPORTIVE PSYCHOTHERAPY); 30 MINUTES

90876 INDIVIDUAL PSYCHOPHYSIOLOGICAL THERAPY INCORPORATING BIOFEEDBACK TRAINING BY ANY MODALITY (FACE-TO-FACE WITH THE PATIENT), WITH PSYCHOTHERAPY (EG, INSIGHT ORIENTED, BEHAVIOR MODIFYING OR SUPPORTIVE PSYCHOTHERAPY); 45 MINUTES

96101 PSYCHOLOGICAL TESTING (INCLUDES PSYCHODIAGNOSTIC ASSESSMENT OF EMOTIONALITY, INTELLECTUAL ABILITIES, PERSONALITY AND PSYCHOPATHOLOGY, EG, MMPI, RORSCHACH, WAIS), PER HOUR OF THE PSYCHOLOGIST’S OR PHYSICIAN’S TIME, BOTH FACE-TO-FACE TIME ADMINISTERING TESTS TO THE PATIENT AND TIME INTERPRETING THESE TEST RESULTS AND PREPARING THE REPORT

96116 NEUROBEHAVIORAL STATUS EXAM (CLINICAL ASSESSMENT OF THINKING, REASONING AND JUDGMENT, EG, ACQUIRED KNOWLEDGE, ATTENTION, LANGUAGE, MEMORY, PLANNING AND PROBLEM SOLVING, AND VISUAL SPATIAL ABILITIES), PER HOUR OF THE PSYCHOLOGIST’S OR PHYSICIAN’S TIME, BOTH FACE-TO-FACE TIME WITH THE PATIENT AND TIME INTERPRETING TEST RESULTS AND PREPARING THE REPORT

96118 NEUROPSYCHOLOGICAL TESTING (EG, HALSTEAD-REITAN NEUROPSYCHOLOGICAL BATTERY, WECHSLER MEMORY SCALES AND WISCONSIN CARD SORTING TEST), PER HOUR OF THE PSYCHOLOGIST’S OR PHYSICIAN’S TIME, BOTH FACE-TO-FACE TIME ADMINISTERING TESTS TO THE PATIENT AND TIME INTERPRETING THESE TEST RESULTS AND PREPARING THE REPORT

97532 DEVELOPMENT OF COGNITIVE SKILLS TO IMPROVE ATTENTION, MEMORY, PROBLEM SOLVING (INCLUDES COMPENSATORY TRAINING), DIRECT (ONE-ON-ONE) PATIENT CONTACT, EACH 15 MINUTES

97533 SENSORY INTEGRATIVE TECHNIQUES TO ENHANCE SENSORY PROCESSING AND PROMOTE ADAPTIVE RESPONSES TO ENVIRONMENTAL DEMANDS, DIRECT (ONE-ON-ONE) PATIENT CONTACT, EACH 15 MINUTES

G0129 OCCUPATIONAL THERAPY SERVICES REQUIRING THE SKILLS OF A QUALIFIED OCCUPATIONAL THERAPIST, FURNISHED AS A COMPONENT OF A PARTIAL HOSPITALIZATION TREATMENT PROGRAM, PER SESSION (45 MINUTES OR MORE)

G0176 ACTIVITY THERAPY, SUCH AS MUSIC, DANCE, ART OR PLAY THERAPIES NOT FOR RECREATION, RELATED TO THE CARE AND TREATMENT OF PATIENT'S DISABLING MENTAL HEALTH PROBLEMS, PER SESSION (45 MINUTES OR MORE)

G0177 TRAINING AND EDUCATIONAL SERVICES RELATED TO THE CARE AND TREATMENT OF PATIENT'S DISABLING MENTAL HEALTH PROBLEMS PER SESSION (45 MINUTES OR MORE)

G0410 GROUP PSYCHOTHERAPY OTHER THAN OF A MULTIPLE-FAMILY GROUP, IN A PARTIAL HOSPITALIZATION SETTING, APPROXIMATELY 45 TO 50 MINUTES

G0411 INTERACTIVE GROUP PSYCHOTHERAPY, IN A PARTIAL HOSPITALIZATION SETTING, APPROXIMATELY 45 TO 50 MINUTES

 

 

ICD-9 Codes that Support Medical Necessity

 

 

290.0 SENILE DEMENTIA UNCOMPLICATED

290.10 PRESENILE DEMENTIA UNCOMPLICATED

290.11 PRESENILE DEMENTIA WITH DELIRIUM

290.12 PRESENILE DEMENTIA WITH DELUSIONAL FEATURES

290.13 PRESENILE DEMENTIA WITH DEPRESSIVE FEATURES

290.20 SENILE DEMENTIA WITH DELUSIONAL FEATURES

290.21 SENILE DEMENTIA WITH DEPRESSIVE FEATURES

290.3 SENILE DEMENTIA WITH DELIRIUM

290.40 VASCULAR DEMENTIA, UNCOMPLICATED

290.41 VASCULAR DEMENTIA, WITH DELIRIUM

290.42 VASCULAR DEMENTIA, WITH DELUSIONS

290.43 VASCULAR DEMENTIA, WITH DEPRESSED MOOD

290.8 OTHER SPECIFIED SENILE PSYCHOTIC CONDITIONS

290.9 UNSPECIFIED SENILE PSYCHOTIC CONDITION

291.0 ALCOHOL WITHDRAWAL DELIRIUM

291.1 ALCOHOL-INDUCED PERSISTING AMNESTIC DISORDER

291.2 ALCOHOL-INDUCED PERSISTING DEMENTIA

291.3 ALCOHOL-INDUCED PSYCHOTIC DISORDER WITH HALLUCINATIONS

291.4 IDIOSYNCRATIC ALCOHOL INTOXICATION

291.5 ALCOHOL-INDUCED PSYCHOTIC DISORDER WITH DELUSIONS

291.81 ALCOHOL WITHDRAWAL

291.82 ALCOHOL INDUCED SLEEP DISORDERS

291.89 OTHER SPECIFIED ALCOHOL-INDUCED MENTAL DISORDERS

291.9 UNSPECIFIED ALCOHOL-INDUCED MENTAL DISORDERS

292.0 DRUG WITHDRAWAL

292.11 DRUG-INDUCED PSYCHOTIC DISORDER WITH DELUSIONS

292.12 DRUG-INDUCED PSYCHOTIC DISORDER WITH HALLUCINATIONS

292.2 PATHOLOGICAL DRUG INTOXICATION

292.81 DRUG-INDUCED DELIRIUM

292.82 DRUG-INDUCED PERSISTING DEMENTIA

292.83 DRUG-INDUCED PERSISTING AMNESTIC DISORDER

292.84 DRUG-INDUCED MOOD DISORDER

292.85 DRUG INDUCED SLEEP DISORDERS

292.89 OTHER SPECIFIED DRUG-INDUCED MENTAL DISORDERS

292.9 UNSPECIFIED DRUG-INDUCED MENTAL DISORDER

293.0 DELIRIUM DUE TO CONDITIONS CLASSIFIED ELSEWHERE

293.1 SUBACUTE DELIRIUM

293.81 PSYCHOTIC DISORDER WITH DELUSIONS IN CONDITIONS CLASSIFIED ELSEWHERE

293.82 PSYCHOTIC DISORDER WITH HALLUCINATIONS IN CONDITIONS CLASSIFIED ELSEWHERE

293.83 MOOD DISORDER IN CONDITIONS CLASSIFIED ELSEWHERE

293.84 ANXIETY DISORDER IN CONDITIONS CLASSIFIED ELSEWHERE

293.89 OTHER SPECIFIED TRANSIENT MENTAL DISORDERS DUE TO CONDITIONS CLASSIFIED ELSEWHERE, OTHER

293.9 UNSPECIFIED TRANSIENT MENTAL DISORDER IN CONDITIONS CLASSIFIED ELSEWHERE

294.0 AMNESTIC DISORDER IN CONDITIONS CLASSIFIED ELSEWHERE

294.10 DEMENTIA IN CONDITIONS CLASSIFIED ELSEWHERE WITHOUT BEHAVIORAL DISTURBANCE

294.11 DEMENTIA IN CONDITIONS CLASSIFIED ELSEWHERE WITH BEHAVIORAL DISTURBANCE

294.20 DEMENTIA, UNSPECIFIED, WITHOUT BEHAVIORAL DISTURBANCE

294.21 DEMENTIA, UNSPECIFIED, WITH BEHAVIORAL DISTURBANCE

294.8 OTHER PERSISTENT MENTAL DISORDERS DUE TO CONDITIONS CLASSIFIED ELSEWHERE

294.9 UNSPECIFIED PERSISTENT MENTAL DISORDERS DUE TO CONDITIONS CLASSIFIED ELSEWHERE

295.00 SIMPLE TYPE SCHIZOPHRENIA UNSPECIFIED STATE

295.01 SIMPLE TYPE SCHIZOPHRENIA SUBCHRONIC STATE

295.02 SIMPLE TYPE SCHIZOPHRENIA CHRONIC STATE

295.03 SIMPLE TYPE SCHIZOPHRENIA SUBCHRONIC STATE WITH ACUTE EXACERBATION

295.04 SIMPLE TYPE SCHIZOPHRENIA CHRONIC STATE WITH ACUTE EXACERBATION

295.05 SIMPLE TYPE SCHIZOPHRENIA IN REMISSION

295.10 DISORGANIZED TYPE SCHIZOPHRENIA UNSPECIFIED STATE

295.11 DISORGANIZED TYPE SCHIZOPHRENIA SUBCHRONIC STATE

295.12 DISORGANIZED TYPE SCHIZOPHRENIA CHRONIC STATE

295.13 DISORGANIZED TYPE SCHIZOPHRENIA SUBCHRONIC STATE WITH ACUTE EXACERBATION

295.14 DISORGANIZED TYPE SCHIZOPHRENIA CHRONIC STATE WITH ACUTE EXACERBATION

295.15 DISORGANIZED TYPE SCHIZOPHRENIA IN REMISSION

295.20 CATATONIC TYPE SCHIZOPHRENIA UNSPECIFIED STATE

295.21 CATATONIC TYPE SCHIZOPHRENIA SUBCHRONIC STATE

295.22 CATATONIC TYPE SCHIZOPHRENIA CHRONIC STATE

295.23 CATATONIC TYPE SCHIZOPHRENIA SUBCHRONIC STATE WITH ACUTE EXACERBATION

295.24 CATATONIC TYPE SCHIZOPHRENIA CHRONIC STATE WITH ACUTE EXACERBATION

295.25 CATATONIC TYPE SCHIZOPHRENIA IN REMISSION

295.30 PARANOID TYPE SCHIZOPHRENIA UNSPECIFIED STATE

295.31 PARANOID TYPE SCHIZOPHRENIA SUBCHRONIC STATE

295.32 PARANOID TYPE SCHIZOPHRENIA CHRONIC STATE

295.33 PARANOID TYPE SCHIZOPHRENIA SUBCHRONIC STATE WITH ACUTE EXACERBATION

295.34 PARANOID TYPE SCHIZOPHRENIA CHRONIC STATE WITH ACUTE EXACERBATION

295.35 PARANOID TYPE SCHIZOPHRENIA IN REMISSION

295.40 SCHIZOPHRENIFORM DISORDER, UNSPECIFIED

295.41 SCHIZOPHRENIFORM DISORDER, SUBCHRONIC

295.42 SCHIZOPHRENIFORM DISORDER, CHRONIC

295.43 SCHIZOPHRENIFORM DISORDER, SUBCHRONIC WITH ACUTE EXACERBATION

295.44 SCHIZOPHRENIFORM DISORDER, CHRONIC WITH ACUTE EXACERBATION

295.45 SCHIZOPHRENIFORM DISORDER, IN REMISSION

295.50 LATENT SCHIZOPHRENIA UNSPECIFIED STATE

295.51 LATENT SCHIZOPHRENIA SUBCHRONIC STATE

295.52 LATENT SCHIZOPHRENIA CHRONIC STATE

295.53 LATENT SCHIZOPHRENIA SUBCHRONIC STATE WITH ACUTE EXACERBATION

295.54 LATENT SCHIZOPHRENIA CHRONIC STATE WITH ACUTE EXACERBATION

295.55 LATENT SCHIZOPHRENIA IN REMISSION

295.60 SCHIZOPHRENIC DISORDERS, RESIDUAL TYPE, UNSPECIFIED

295.61 SCHIZOPHRENIC DISORDERS, RESIDUAL TYPE, SUBCHRONIC

295.62 SCHIZOPHRENIC DISORDERS, RESIDUAL TYPE, CHRONIC

295.63 SCHIZOPHRENIC DISORDERS, RESIDUAL TYPE, SUBCHRONIC WITH ACUTE EXACERBATION

295.64 SCHIZOPHRENIC DISORDERS, RESIDUAL TYPE, CHRONIC WITH ACUTE EXACERBATION

295.65 SCHIZOPHRENIC DISORDERS, RESIDUAL TYPE, IN REMISSION

295.70 SCHIZOAFFECTIVE DISORDER, UNSPECIFIED

295.71 SCHIZOAFFECTIVE DISORDER, SUBCHRONIC

295.72 SCHIZOAFFECTIVE DISORDER, CHRONIC

295.73 SCHIZOAFFECTIVE DISORDER, SUBCHRONIC WITH ACUTE EXACERBATION

295.74 SCHIZOAFFECTIVE DISORDER, CHRONIC WITH ACUTE EXACERBATION

295.75 SCHIZOAFFECTIVE DISORDER, IN REMISSION

295.80 OTHER SPECIFIED TYPES OF SCHIZOPHRENIA UNSPECIFIED STATE

295.81 OTHER SPECIFIED TYPES OF SCHIZOPHRENIA SUBCHRONIC STATE

295.82 OTHER SPECIFIED TYPES OF SCHIZOPHRENIA CHRONIC STATE

295.83 OTHER SPECIFIED TYPES OF SCHIZOPHRENIA SUBCHRONIC STATE WITH ACUTE EXACERBATION

295.84 OTHER SPECIFIED TYPES OF SCHIZOPHRENIA CHRONIC STATE WITH ACUTE EXACERBATION

295.85 OTHER SPECIFIED TYPES OF SCHIZOPHRENIA IN REMISSION

295.90 UNSPECIFIED TYPE SCHIZOPHRENIA UNSPECIFIED STATE

295.91 UNSPECIFIED TYPE SCHIZOPHRENIA SUBCHRONIC STATE

295.92 UNSPECIFIED TYPE SCHIZOPHRENIA CHRONIC STATE

295.93 UNSPECIFIED TYPE SCHIZOPHRENIA SUBCHRONIC STATE WITH ACUTE EXACERBATION

295.94 UNSPECIFIED TYPE SCHIZOPHRENIA CHRONIC STATE WITH ACUTE EXACERBATION

295.95 UNSPECIFIED TYPE SCHIZOPHRENIA IN REMISSION

296.00 BIPOLAR I DISORDER, SINGLE MANIC EPISODE, UNSPECIFIED

296.01 BIPOLAR I DISORDER, SINGLE MANIC EPISODE, MILD

296.02 BIPOLAR I DISORDER, SINGLE MANIC EPISODE, MODERATE

296.03 BIPOLAR I DISORDER, SINGLE MANIC EPISODE, SEVERE, WITHOUT MENTION OF PSYCHOTIC BEHAVIOR

296.04 BIPOLAR I DISORDER, SINGLE MANIC EPISODE, SEVERE, SPECIFIED AS WITH PSYCHOTIC BEHAVIOR

296.05 BIPOLAR I DISORDER, SINGLE MANIC EPISODE, IN PARTIAL OR UNSPECIFIED REMISSION

296.06 BIPOLAR I DISORDER, SINGLE MANIC EPISODE, IN FULL REMISSION

296.10 MANIC AFFECTIVE DISORDER RECURRENT EPISODE UNSPECIFIED DEGREE

296.11 MANIC AFFECTIVE DISORDER RECURRENT EPISODE MILD DEGREE

296.12 MANIC AFFECTIVE DISORDER RECURRENT EPISODE MODERATE DEGREE

296.13 MANIC AFFECTIVE DISORDER RECURRENT EPISODE SEVERE DEGREE WITHOUT PSYCHOTIC BEHAVIOR

296.14 MANIC AFFECTIVE DISORDER RECURRENT EPISODE SEVERE DEGREE SPECIFIED AS WITH PSYCHOTIC BEHAVIOR

296.15 MANIC AFFECTIVE DISORDER RECURRENT EPISODE IN PARTIAL OR UNSPECIFIED REMISSION

296.16 MANIC AFFECTIVE DISORDER RECURRENT EPISODE IN FULL REMISSION

296.20 MAJOR DEPRESSIVE AFFECTIVE DISORDER SINGLE EPISODE UNSPECIFIED DEGREE

296.21 MAJOR DEPRESSIVE AFFECTIVE DISORDER SINGLE EPISODE MILD DEGREE

296.22 MAJOR DEPRESSIVE AFFECTIVE DISORDER SINGLE EPISODE MODERATE DEGREE

296.23 MAJOR DEPRESSIVE AFFECTIVE DISORDER SINGLE EPISODE SEVERE DEGREE WITHOUT PSYCHOTIC BEHAVIOR

296.24 MAJOR DEPRESSIVE AFFECTIVE DISORDER SINGLE EPISODE SEVERE DEGREE SPECIFIED AS WITH PSYCHOTIC BEHAVIOR

296.25 MAJOR DEPRESSIVE AFFECTIVE DISORDER SINGLE EPISODE IN PARTIAL OR UNSPECIFIED REMISSION

296.26 MAJOR DEPRESSIVE AFFECTIVE DISORDER SINGLE EPISODE IN FULL REMISSION

296.30 MAJOR DEPRESSIVE AFFECTIVE DISORDER RECURRENT EPISODE UNSPECIFIED DEGREE

296.31 MAJOR DEPRESSIVE AFFECTIVE DISORDER RECURRENT EPISODE MILD DEGREE

296.32 MAJOR DEPRESSIVE AFFECTIVE DISORDER RECURRENT EPISODE MODERATE DEGREE

296.33 MAJOR DEPRESSIVE AFFECTIVE DISORDER RECURRENT EPISODE SEVERE DEGREE WITHOUT PSYCHOTIC BEHAVIOR

296.34 MAJOR DEPRESSIVE AFFECTIVE DISORDER RECURRENT EPISODE SEVERE DEGREE SPECIFIED AS WITH PSYCHOTIC BEHAVIOR

296.35 MAJOR DEPRESSIVE AFFECTIVE DISORDER RECURRENT EPISODE IN PARTIAL OR UNSPECIFIED REMISSION

296.36 MAJOR DEPRESSIVE AFFECTIVE DISORDER RECURRENT EPISODE IN FULL REMISSION

296.40 BIPOLAR I DISORDER, MOST RECENT EPISODE (OR CURRENT) MANIC, UNSPECIFIED

296.41 BIPOLAR I DISORDER, MOST RECENT EPISODE (OR CURRENT) MANIC, MILD

296.42 BIPOLAR I DISORDER, MOST RECENT EPISODE (OR CURRENT) MANIC, MODERATE

296.43 BIPOLAR I DISORDER, MOST RECENT EPISODE (OR CURRENT) MANIC, SEVERE, WITHOUT MENTION OF PSYCHOTIC BEHAVIOR

296.44 BIPOLAR I DISORDER, MOST RECENT EPISODE (OR CURRENT) MANIC, SEVERE, SPECIFIED AS WITH PSYCHOTIC BEHAVIOR

296.45 BIPOLAR I DISORDER, MOST RECENT EPISODE (OR CURRENT) MANIC, IN PARTIAL OR UNSPECIFIED REMISSION

296.46 BIPOLAR I DISORDER, MOST RECENT EPISODE (OR CURRENT) MANIC, IN FULL REMISSION

296.50 BIPOLAR I DISORDER, MOST RECENT EPISODE (OR CURRENT) DEPRESSED, UNSPECIFIED

296.51 BIPOLAR I DISORDER, MOST RECENT EPISODE (OR CURRENT) DEPRESSED, MILD

296.52 BIPOLAR I DISORDER, MOST RECENT EPISODE (OR CURRENT) DEPRESSED, MODERATE

296.53 BIPOLAR I DISORDER, MOST RECENT EPISODE (OR CURRENT) DEPRESSED, SEVERE, WITHOUT MENTION OF PSYCHOTIC BEHAVIOR

296.54 BIPOLAR I DISORDER, MOST RECENT EPISODE (OR CURRENT) DEPRESSED, SEVERE, SPECIFIED AS WITH PSYCHOTIC BEHAVIOR

296.55 BIPOLAR I DISORDER, MOST RECENT EPISODE (OR CURRENT) DEPRESSED, IN PARTIAL OR UNSPECIFIED REMISSION

296.56 BIPOLAR I DISORDER, MOST RECENT EPISODE (OR CURRENT) DEPRESSED, IN FULL REMISSION

296.60 BIPOLAR I DISORDER, MOST RECENT EPISODE (OR CURRENT) MIXED, UNSPECIFIED

296.61 BIPOLAR I DISORDER, MOST RECENT EPISODE (OR CURRENT) MIXED, MILD

296.62 BIPOLAR I DISORDER, MOST RECENT EPISODE (OR CURRENT) MIXED, MODERATE

296.63 BIPOLAR I DISORDER, MOST RECENT EPISODE (OR CURRENT) MIXED, SEVERE, WITHOUT MENTION OF PSYCHOTIC BEHAVIOR

296.64 BIPOLAR I DISORDER, MOST RECENT EPISODE (OR CURRENT) MIXED, SEVERE, SPECIFIED AS WITH PSYCHOTIC BEHAVIOR

296.65 BIPOLAR I DISORDER, MOST RECENT EPISODE (OR CURRENT) MIXED, IN PARTIAL OR UNSPECIFIED REMISSION

296.66 BIPOLAR I DISORDER, MOST RECENT EPISODE (OR CURRENT) MIXED, IN FULL REMISSION

296.7 BIPOLAR I DISORDER, MOST RECENT EPISODE (OR CURRENT) UNSPECIFIED

296.80 BIPOLAR DISORDER, UNSPECIFIED

296.81 ATYPICAL MANIC DISORDER

296.82 ATYPICAL DEPRESSIVE DISORDER

296.89 OTHER AND UNSPECIFIED BIPOLAR DISORDERS, OTHER

296.90 UNSPECIFIED EPISODIC MOOD DISORDER

296.99 OTHER SPECIFIED EPISODIC MOOD DISORDER

297.0 PARANOID STATE SIMPLE

297.1 DELUSIONAL DISORDER

297.2 PARAPHRENIA

297.3 SHARED PSYCHOTIC DISORDER

297.8 OTHER SPECIFIED PARANOID STATES

297.9 UNSPECIFIED PARANOID STATE

298.0 DEPRESSIVE TYPE PSYCHOSIS

298.1 EXCITATIVE TYPE PSYCHOSIS

298.2 REACTIVE CONFUSION

298.3 ACUTE PARANOID REACTION

298.4 PSYCHOGENIC PARANOID PSYCHOSIS

298.8 OTHER AND UNSPECIFIED REACTIVE PSYCHOSIS

298.9 UNSPECIFIED PSYCHOSIS

299.00 AUTISTIC DISORDER, CURRENT OR ACTIVE STATE

299.01 AUTISTIC DISORDER, RESIDUAL STATE

299.10 CHILDHOOD DISINTEGRATIVE DISORDER, CURRENT OR ACTIVE STATE

299.11 CHILDHOOD DISINTEGRATIVE DISORDER, RESIDUAL STATE

299.80 OTHER SPECIFIED PERVASIVE DEVELOPMENTAL DISORDERS, CURRENT OR ACTIVE STATE

299.81 OTHER SPECIFIED PERVASIVE DEVELOPMENTAL DISORDERS, RESIDUAL STATE

299.90 UNSPECIFIED PERVASIVE DEVELOPMENTAL DISORDER, CURRENT OR ACTIVE STATE

299.91 UNSPECIFIED PERVASIVE DEVELOPMENTAL DISORDER, RESIDUAL STATE

300.00 ANXIETY STATE UNSPECIFIED

300.01 PANIC DISORDER WITHOUT AGORAPHOBIA

300.02 GENERALIZED ANXIETY DISORDER

300.09 OTHER ANXIETY STATES

300.10 HYSTERIA UNSPECIFIED

300.11 CONVERSION DISORDER

300.12 DISSOCIATIVE AMNESIA

300.13 DISSOCIATIVE FUGUE

300.14 DISSOCIATIVE IDENTITY DISORDER

300.15 DISSOCIATIVE DISORDER OR REACTION UNSPECIFIED

300.16 FACTITIOUS DISORDER WITH PREDOMINANTLY PSYCHOLOGICAL SIGNS AND SYMPTOMS

300.19 OTHER AND UNSPECIFIED FACTITIOUS ILLNESS

300.20 PHOBIA UNSPECIFIED

300.21 AGORAPHOBIA WITH PANIC DISORDER

300.22 AGORAPHOBIA WITHOUT PANIC ATTACKS

300.23 SOCIAL PHOBIA

300.29 OTHER ISOLATED OR SPECIFIC PHOBIAS

300.3 OBSESSIVE-COMPULSIVE DISORDERS

300.4 DYSTHYMIC DISORDER

300.5 NEURASTHENIA

300.6 DEPERSONALIZATION DISORDER

300.7 HYPOCHONDRIASIS

300.81 SOMATIZATION DISORDER

300.82 UNDIFFERENTIATED SOMATOFORM DISORDER

300.89 OTHER SOMATOFORM DISORDERS

300.9 UNSPECIFIED NONPSYCHOTIC MENTAL DISORDER

301.0 PARANOID PERSONALITY DISORDER

301.10 AFFECTIVE PERSONALITY DISORDER UNSPECIFIED

301.11 CHRONIC HYPOMANIC PERSONALITY DISORDER

301.12 CHRONIC DEPRESSIVE PERSONALITY DISORDER

301.13 CYCLOTHYMIC DISORDER

301.20 SCHIZOID PERSONALITY DISORDER UNSPECIFIED

301.21 INTROVERTED PERSONALITY

301.22 SCHIZOTYPAL PERSONALITY DISORDER

301.3 EXPLOSIVE PERSONALITY DISORDER

301.4 OBSESSIVE-COMPULSIVE PERSONALITY DISORDER

301.50 HISTRIONIC PERSONALITY DISORDER UNSPECIFIED

301.51 CHRONIC FACTITIOUS ILLNESS WITH PHYSICAL SYMPTOMS

301.59 OTHER HISTRIONIC PERSONALITY DISORDER

301.6 DEPENDENT PERSONALITY DISORDER

301.7 ANTISOCIAL PERSONALITY DISORDER

301.81 NARCISSISTIC PERSONALITY DISORDER

301.82 AVOIDANT PERSONALITY DISORDER

301.83 BORDERLINE PERSONALITY DISORDER

301.84 PASSIVE-AGGRESSIVE PERSONALITY

301.89 OTHER PERSONALITY DISORDERS

301.9 UNSPECIFIED PERSONALITY DISORDER

302.0 EGO-DYSTONIC SEXUAL ORIENTATION

302.1 ZOOPHILIA

302.2 PEDOPHILIA

302.3 TRANSVESTIC FETISHISM

302.4 EXHIBITIONISM

302.50 TRANS-SEXUALISM WITH UNSPECIFIED SEXUAL HISTORY

302.51 TRANS-SEXUALISM WITH ASEXUAL HISTORY

302.52 TRANS-SEXUALISM WITH HOMOSEXUAL HISTORY

302.53 TRANS-SEXUALISM WITH HETEROSEXUAL HISTORY

302.6 GENDER IDENTITY DISORDER IN CHILDREN

302.70 PSYCHOSEXUAL DYSFUNCTION UNSPECIFIED

302.71 HYPOACTIVE SEXUAL DESIRE DISORDER

302.72 PSYCHOSEXUAL DYSFUNCTION WITH INHIBITED SEXUAL EXCITEMENT

302.73 FEMALE ORGASMIC DISORDER

302.74 MALE ORGASMIC DISORDER

302.75 PREMATURE EJACULATION

302.76 DYSPAREUNIA, PSYCHOGENIC

302.79 PSYCHOSEXUAL DYSFUNCTION WITH OTHER SPECIFIED PSYCHOSEXUAL DYSFUNCTIONS

302.81 FETISHISM

302.82 VOYEURISM

302.83 SEXUAL MASOCHISM

302.84 SEXUAL SADISM

302.85 GENDER IDENTITY DISORDER IN ADOLESCENTS OR ADULTS

302.89 OTHER SPECIFIED PSYCHOSEXUAL DISORDERS

302.9 UNSPECIFIED PSYCHOSEXUAL DISORDER

303.00 ACUTE ALCOHOLIC INTOXICATION IN ALCOHOLISM UNSPECIFIED DRINKING BEHAVIOR

303.01 ACUTE ALCOHOLIC INTOXICATION IN ALCOHOLISM CONTINUOUS DRINKING BEHAVIOR

303.02 ACUTE ALCOHOLIC INTOXICATION IN ALCOHOLISM EPISODIC DRINKING BEHAVIOR

303.03 ACUTE ALCOHOLIC INTOXICATION IN ALCOHOLISM IN REMISSION

303.90 OTHER AND UNSPECIFIED ALCOHOL DEPENDENCE UNSPECIFIED DRINKING BEHAVIOR

303.91 OTHER AND UNSPECIFIED ALCOHOL DEPENDENCE CONTINUOUS DRINKING BEHAVIOR

303.92 OTHER AND UNSPECIFIED ALCOHOL DEPENDENCE EPISODIC DRINKING BEHAVIOR

303.93 OTHER AND UNSPECIFIED ALCOHOL DEPENDENCE IN REMISSION

304.00 OPIOID TYPE DEPENDENCE UNSPECIFIED USE

304.01 OPIOID TYPE DEPENDENCE CONTINUOUS USE

304.02 OPIOID TYPE DEPENDENCE EPISODIC USE

304.03 OPIOID TYPE DEPENDENCE IN REMISSION

304.10 SEDATIVE, HYPNOTIC OR ANXIOLYTIC DEPENDENCE, UNSPECIFIED

304.11 SEDATIVE, HYPNOTIC OR ANXIOLYTIC DEPENDENCE, CONTINUOUS

304.12 SEDATIVE, HYPNOTIC OR ANXIOLYTIC DEPENDENCE, EPISODIC

304.13 SEDATIVE, HYPNOTIC OR ANXIOLYTIC DEPENDENCE, IN REMISSION

304.20 COCAINE DEPENDENCE UNSPECIFIED USE

304.21 COCAINE DEPENDENCE CONTINUOUS USE

304.22 COCAINE DEPENDENCE EPISODIC USE

304.23 COCAINE DEPENDENCE IN REMISSION

304.30 CANNABIS DEPENDENCE UNSPECIFIED USE

304.31 CANNABIS DEPENDENCE CONTINUOUS USE

304.32 CANNABIS DEPENDENCE EPISODIC USE

304.33 CANNABIS DEPENDENCE IN REMISSION

304.40 AMPHETAMINE AND OTHER PSYCHOSTIMULANT DEPENDENCE UNSPECIFIED USE

304.41 AMPHETAMINE AND OTHER PSYCHOSTIMULANT DEPENDENCE CONTINUOUS USE

304.42 AMPHETAMINE AND OTHER PSYCHOSTIMULANT DEPENDENCE EPISODIC USE

304.43 AMPHETAMINE AND OTHER PSYCHOSTIMULANT DEPENDENCE IN REMISSION

304.50 HALLUCINOGEN DEPENDENCE UNSPECIFIED USE

304.51 HALLUCINOGEN DEPENDENCE CONTINUOUS USE

304.52 HALLUCINOGEN DEPENDENCE EPISODIC USE

304.53 HALLUCINOGEN DEPENDENCE IN REMISSION

304.60 OTHER SPECIFIED DRUG DEPENDENCE UNSPECIFIED USE

304.61 OTHER SPECIFIED DRUG DEPENDENCE CONTINUOUS USE

304.62 OTHER SPECIFIED DRUG DEPENDENCE EPISODIC USE

304.63 OTHER SPECIFIED DRUG DEPENDENCE IN REMISSION

304.70 COMBINATIONS OF OPIOID TYPE DRUG WITH ANY OTHER DRUG DEPENDENCE UNSPECIFIED USE

304.71 COMBINATIONS OF OPIOID TYPE DRUG WITH ANY OTHER DRUG DEPENDENCE CONTINUOUS USE

304.72 COMBINATIONS OF OPIOID TYPE DRUG WITH ANY OTHER DRUG DEPENDENCE EPISODIC USE

304.73 COMBINATIONS OF OPIOID TYPE DRUG WITH ANY OTHER DRUG DEPENDENCE IN REMISSION

304.80 COMBINATIONS OF DRUG DEPENDENCE EXCLUDING OPIOID TYPE DRUG UNSPECIFIED USE

304.81 COMBINATIONS OF DRUG DEPENDENCE EXCLUDING OPIOID TYPE DRUG CONTINUOUS USE

304.82 COMBINATIONS OF DRUG DEPENDENCE EXCLUDING OPIOID TYPE DRUG EPISODIC USE

304.83 COMBINATIONS OF DRUG DEPENDENCE EXCLUDING OPIOID TYPE DRUG IN REMISSION

304.90 UNSPECIFIED DRUG DEPENDENCE UNSPECIFIED USE

304.91 UNSPECIFIED DRUG DEPENDENCE CONTINUOUS USE

304.92 UNSPECIFIED DRUG DEPENDENCE EPISODIC USE

304.93 UNSPECIFIED DRUG DEPENDENCE IN REMISSION

305.00 NONDEPENDENT ALCOHOL ABUSE UNSPECIFIED DRINKING BEHAVIOR

305.01 NONDEPENDENT ALCOHOL ABUSE CONTINUOUS DRINKING BEHAVIOR

305.02 NONDEPENDENT ALCOHOL ABUSE EPISODIC DRINKING BEHAVIOR

305.03 NONDEPENDENT ALCOHOL ABUSE IN REMISSION

305.1 NONDEPENDENT TOBACCO USE DISORDER

305.20 NONDEPENDENT CANNABIS ABUSE UNSPECIFIED USE

305.21 NONDEPENDENT CANNABIS ABUSE CONTINUOUS USE

305.22 NONDEPENDENT CANNABIS ABUSE EPISODIC USE

305.23 NONDEPENDENT CANNABIS ABUSE IN REMISSION

305.30 NONDEPENDENT HALLUCINOGEN ABUSE UNSPECIFIED USE

305.31 NONDEPENDENT HALLUCINOGEN ABUSE CONTINUOUS USE

305.32 NONDEPENDENT HALLUCINOGEN ABUSE EPISODIC USE

305.33 NONDEPENDENT HALLUCINOGEN ABUSE IN REMISSION

305.40 SEDATIVE, HYPNOTIC OR ANXIOLYTIC ABUSE, UNSPECIFIED

305.41 SEDATIVE, HYPNOTIC OR ANXIOLYTIC ABUSE, CONTINUOUS

305.42 SEDATIVE, HYPNOTIC OR ANXIOLYTIC ABUSE, EPISODIC

305.43 SEDATIVE, HYPNOTIC OR ANXIOLYTIC ABUSE, IN REMISSION

305.50 NONDEPENDENT OPIOID ABUSE UNSPECIFIED USE

305.51 NONDEPENDENT OPIOID ABUSE CONTINUOUS USE

305.52 NONDEPENDENT OPIOID ABUSE EPISODIC USE

305.53 NONDEPENDENT OPIOID ABUSE IN REMISSION

305.60 NONDEPENDENT COCAINE ABUSE UNSPECIFIED USE

305.61 NONDEPENDENT COCAINE ABUSE CONTINUOUS USE

305.62 NONDEPENDENT COCAINE ABUSE EPISODIC USE

305.63 NONDEPENDENT COCAINE ABUSE IN REMISSION

305.70 NONDEPENDENT AMPHETAMINE OR RELATED ACTING SYMPATHOMIMETIC ABUSE UNSPECIFIED USE

305.71 NONDEPENDENT AMPHETAMINE OR RELATED ACTING SYMPATHOMIMETIC ABUSE CONTINUOUS USE

305.72 NONDEPENDENT AMPHETAMINE OR RELATED ACTING SYMPATHOMIMETIC ABUSE EPISODIC USE

305.73 NONDEPENDENT AMPHETAMINE OR RELATED ACTING SYMPATHOMIMETIC ABUSE IN REMISSION

305.80 NONDEPENDENT ANTIDEPRESSANT TYPE ABUSE UNSPECIFIED USE

305.81 NONDEPENDENT ANTIDEPRESSANT TYPE ABUSE CONTINUOUS USE

305.82 NONDEPENDENT ANTIDEPRESSANT TYPE ABUSE EPISODIC USE

305.83 NONDEPENDENT ANTIDEPRESSANT TYPE ABUSE IN REMISSION

305.90 OTHER MIXED OR UNSPECIFIED DRUG ABUSE UNSPECIFIED USE

305.91 NONDEPENDENT OTHER MIXED OR UNSPECIFIED DRUG ABUSE CONTINUOUS USE

305.92 NONDEPENDENT OTHER MIXED OR UNSPECIFIED DRUG ABUSE EPISODIC USE

305.93 NONDEPENDENT OTHER MIXED OR UNSPECIFIED DRUG ABUSE IN REMISSION

306.0 MUSCULOSKELETAL MALFUNCTION ARISING FROM MENTAL FACTORS

306.1 RESPIRATORY MALFUNCTION ARISING FROM MENTAL FACTORS

306.2 CARDIOVASCULAR MALFUNCTION ARISING FROM MENTAL FACTORS

306.3 SKIN DISORDER ARISING FROM MENTAL FACTORS

306.4 GASTROINTESTINAL MALFUNCTION ARISING FROM MENTAL FACTORS

306.50 PSYCHOGENIC GENITOURINARY MALFUNCTION UNSPECIFIED

306.51 PSYCHOGENIC VAGINISMUS

306.52 PSYCHOGENIC DYSMENORRHEA

306.53 PSYCHOGENIC DYSURIA

306.59 OTHER GENITOURINARY MALFUNCTION ARISING FROM MENTAL FACTORS

306.6 ENDOCRINE DISORDER ARISING FROM MENTAL FACTORS

306.7 DISORDER OF ORGANS OF SPECIAL SENSE ARISING FROM MENTAL FACTORS

306.8 OTHER SPECIFIED PSYCHOPHYSIOLOGICAL MALFUNCTION

306.9 UNSPECIFIED PSYCHOPHYSIOLOGICAL MALFUNCTION

307.0 ADULT ONSET FLUENCY DISORDER

307.1 ANOREXIA NERVOSA

307.20 TIC DISORDER UNSPECIFIED

307.21 TRANSIENT TIC DISORDER

307.22 CHRONIC MOTOR OR VOCAL TIC DISORDER

307.23 TOURETTE’S DISORDER

307.3 STEREOTYPIC MOVEMENT DISORDER

307.40 NONORGANIC SLEEP DISORDER UNSPECIFIED

307.41 TRANSIENT DISORDER OF INITIATING OR MAINTAINING SLEEP

307.42 PERSISTENT DISORDER OF INITIATING OR MAINTAINING SLEEP

307.43 TRANSIENT DISORDER OF INITIATING OR MAINTAINING WAKEFULNESS

307.44 PERSISTENT DISORDER OF INITIATING OR MAINTAINING WAKEFULNESS

307.45 CIRCADIAN RHYTHM SLEEP DISORDER OF NONORGANIC ORIGIN

307.46 SLEEP AROUSAL DISORDER

307.47 OTHER DYSFUNCTIONS OF SLEEP STAGES OR AROUSAL FROM SLEEP

307.48 REPETITIVE INTRUSIONS OF SLEEP

307.49 OTHER SPECIFIC DISORDERS OF SLEEP OF NONORGANIC ORIGIN

307.50 EATING DISORDER UNSPECIFIED

307.51 BULIMIA NERVOSA

307.52 PICA

307.53 RUMINATION DISORDER

307.54 PSYCHOGENIC VOMITING

307.59 OTHER DISORDERS OF EATING

307.6 ENURESIS

307.7 ENCOPRESIS

307.80 PSYCHOGENIC PAIN SITE UNSPECIFIED

307.81 TENSION HEADACHE

307.89 OTHER, PAIN DISORDER RELATED TO PSYCHOLOGICAL FACTORS

307.9 OTHER AND UNSPECIFIED SPECIAL SYMPTOMS OR SYNDROMES NOT ELSEWHERE CLASSIFIED

308.0 PREDOMINANT DISTURBANCE OF EMOTIONS

308.1 PREDOMINANT DISTURBANCE OF CONSCIOUSNESS

308.2 PREDOMINANT PSYCHOMOTOR DISTURBANCE

308.3 OTHER ACUTE REACTIONS TO STRESS

308.4 MIXED DISORDERS AS REACTION TO STRESS

308.9 UNSPECIFIED ACUTE REACTION TO STRESS

309.0 ADJUSTMENT DISORDER WITH DEPRESSED MOOD

309.1 ADJUSTMENT REACTION WITH PROLONGED DEPRESSIVE REACTION

309.21 SEPARATION ANXIETY DISORDER

309.22 EMANCIPATION DISORDER OF ADOLESCENCE AND EARLY ADULT LIFE

309.23 SPECIFIC ACADEMIC OR WORK INHIBITION

309.24 ADJUSTMENT DISORDER WITH ANXIETY

309.28 ADJUSTMENT DISORDER WITH MIXED ANXIETY AND DEPRESSED MOOD

309.29 OTHER ADJUSTMENT REACTIONS WITH PREDOMINANT DISTURBANCE OF OTHER EMOTIONS

309.3 ADJUSTMENT DISORDER WITH DISTURBANCE OF CONDUCT

309.4 ADJUSTMENT DISORDER WITH MIXED DISBURBANCE OF EMOTIONS AND CONDUCT

309.81 POSTTRAUMATIC STRESS DISORDER

309.82 ADJUSTMENT REACTION WITH PHYSICAL SYMPTOMS

309.83 ADJUSTMENT REACTION WITH WITHDRAWAL

309.89 OTHER SPECIFIED ADJUSTMENT REACTIONS

309.9 UNSPECIFIED ADJUSTMENT REACTION

310.0 FRONTAL LOBE SYNDROME

310.1 PERSONALITY CHANGE DUE TO CONDITIONS CLASSIFIED ELSEWHERE

310.2 POSTCONCUSSION SYNDROME

310.81 PSEUDOBULBAR AFFECT

310.89 OTHER SPECIFIED NONPSYCHOTIC MENTAL DISORDERS FOLLOWING ORGANIC BRAIN DAMAGE

310.9 UNSPECIFIED NONPSYCHOTIC MENTAL DISORDER FOLLOWING ORGANIC BRAIN DAMAGE

311 DEPRESSIVE DISORDER NOT ELSEWHERE CLASSIFIED

312.00 UNDERSOCIALIZED CONDUCT DISORDER AGGRESSIVE TYPE UNSPECIFIED DEGREE

312.01 UNDERSOCIALIZED CONDUCT DISORDER AGGRESSIVE TYPE MILD DEGREE

312.02 UNDERSOCIALIZED CONDUCT DISORDER AGGRESSIVE TYPE MODERATE DEGREE

312.03 UNDERSOCIALIZED CONDUCT DISORDER AGGRESSIVE TYPE SEVERE DEGREE

312.10 UNDERSOCIALIZED CONDUCT DISORDER UNAGGRESSIVE TYPE UNSPECIFIED DEGREE

312.11 UNDERSOCIALIZED CONDUCT DISORDER UNAGGRESSIVE TYPE MILD DEGREE

312.12 UNDERSOCIALIZED CONDUCT DISORDER UNAGGRESSIVE TYPE MODERATE DEGREE

312.13 UNDERSOCIALIZED CONDUCT DISORDER UNAGGRESSIVE TYPE SEVERE DEGREE

312.20 SOCIALIZED CONDUCT DISORDER UNSPECIFIED DEGREE

312.21 SOCIALIZED CONDUCT DISORDER MILD DEGREE

312.22 SOCIALIZED CONDUCT DISORDER MODERATE DEGREE

312.23 SOCIALIZED CONDUCT DISORDER SEVERE DEGREE

312.30 IMPULSE CONTROL DISORDER UNSPECIFIED

312.31 PATHOLOGICAL GAMBLING

312.32 KLEPTOMANIA

312.33 PYROMANIA

312.34 INTERMITTENT EXPLOSIVE DISORDER

312.35 ISOLATED EXPLOSIVE DISORDER

312.39 OTHER DISORDERS OF IMPULSE CONTROL

312.4 MIXED DISTURBANCE OF CONDUCT AND EMOTIONS

312.81 CONDUCT DISORDER CHILDHOOD ONSET TYPE

312.82 CONDUCT DISORDER ADOLESCENT ONSET TYPE

312.89 OTHER SPECIFIED CONDUCT DISORDER NOT ELSEWHERE CLASSIFIED

312.9 UNSPECIFIED DISTURBANCE OF CONDUCT

313.0 OVERANXIOUS DISORDER SPECIFIC TO CHILDHOOD AND ADOLESCENCE

313.1 MISERY AND UNHAPPINESS DISORDER SPECIFIC TO CHILDHOOD AND ADOLESCENCE

313.21 SHYNESS DISORDER OF CHILDHOOD

313.22 INTROVERTED DISORDER OF CHILDHOOD

313.23 SELECTIVE MUTISM

313.3 RELATIONSHIP PROBLEMS SPECIFIC TO CHILDHOOD AND ADOLESCENCE

313.81 OPPOSITIONAL DEFIANT DISORDER

313.82 IDENTITY DISORDER OF CHILDHOOD OR ADOLESCENCE

313.83 ACADEMIC UNDERACHIEVEMENT DISORDER OF CHILDHOOD OR ADOLESCENCE

313.89 OTHER EMOTIONAL DISTURBANCES OF CHILDHOOD OR ADOLESCENCE

313.9 UNSPECIFIED EMOTIONAL DISTURBANCE OF CHILDHOOD OR ADOLESCENCE

314.00 ATTENTION DEFICIT DISORDER OF CHILDHOOD WITHOUT HYPERACTIVITY

314.01 ATTENTION DEFICIT DISORDER OF CHILDHOOD WITH HYPERACTIVITY

314.1 HYPERKINESIS OF CHILDHOOD WITH DEVELOPMENTAL DELAY

314.2 HYPERKINETIC CONDUCT DISORDER OF CHILDHOOD

314.8 OTHER SPECIFIED MANIFESTATIONS OF HYPERKINETIC SYNDROME OF CHILDHOOD

314.9 UNSPECIFIED HYPERKINETIC SYNDROME OF CHILDHOOD

315.00 DEVELOPMENTAL READING DISORDER UNSPECIFIED

315.01 ALEXIA

315.02 DEVELOPMENTAL DYSLEXIA

315.09 OTHER SPECIFIC DEVELOPMENTAL READING DISORDER

315.1 MATHEMATICS DISORDER

315.2 OTHER SPECIFIC DEVELOPMENTAL LEARNING DIFFICULTIES

315.31 EXPRESSIVE LANGUAGE DISORDER

315.32 MIXED RECEPTIVE-EXPRESSIVE LANGUAGE DISORDER

315.34 SPEECH AND LANGUAGE DEVELOPMENTAL DELAY DUE TO HEARING LOSS

315.35 CHILDHOOD ONSET FLUENCY DISORDER

315.39 OTHER DEVELOPMENTAL SPEECH DISORDER

315.4 DEVELOPMENTAL COORDINATION DISORDER

315.5 MIXED DEVELOPMENT DISORDER

315.8 OTHER SPECIFIED DELAYS IN DEVELOPMENT

315.9 UNSPECIFIED DELAY IN DEVELOPMENT

316 PSYCHIC FACTORS ASSOCIATED WITH DISEASES CLASSIFIED ELSEWHERE

317 MILD INTELLECTUAL DISABILITIES

318.0 MODERATE INTELLECTUAL DISABILITIES

318.1 SEVERE INTELLECTUAL DISABILITIES

318.2 PROFOUND INTELLECTUAL DISABILITIES

 

 

Documentation Requirements

• Physical examination upon admission (if not done within the past 30 days and/or not available from another provider) must be included in the medical record.

• Medical record documentation maintained by the provider must indicate the medical necessity of each psychotherapy session and include the following:

o The presence of a psychiatric illness and/or the demonstration of emotional or behavioral symptoms sufficient to alter baseline functioning.

And

o A detailed summary of the psychotherapy session, including descriptive documentation of therapeutic interventions such as examples of attempted behavior modification, supportive interaction, and discussion of reality.

And

o The degree of patient participation and interaction with the therapist, the reaction of the patient to the therapy session, documentation toward goal oriented outcomes and the changes or lack of changes in patient symptoms and/or behavior as a result of the psychotherapy session.

o The rationale for any departure from the plan or extension of therapy should be documented in the medical record.

 The therapist must document patient/therapist interaction in addition to an assessment of the patients’ problems.

o Interaction of the patient on the unit with staff members as well as other participants when applicable.

o Clear, concise documentation of individual and group therapy sessions, updates regarding diagnoses as evidenced by changes in signs and symptoms and interactions within the facility.

•

• Psychotherapy notes are defined in 45 CFR §164.501as “notes recorded by a mental health professional which document or analyze the contents of a counseling session and that are separated from the rest of a medical record.”

o The definition of psychotherapy notes expressly EXCLUDES:

 Medication prescription and monitoring.

 Counseling session start and stop times.

 The modalities and frequencies of treatment furnished.

 Results of clinical tests, and any summary of diagnosis.

 Functional status.

 Treatment plan, symptoms, prognosis, progress, and progress to date etc., and this class of information do NOT qualify as psychotherapy note material.

o Physically integrating information excluded from the definition of psychotherapy notes and protected information into one document or record does not transform the non-protected information into protected psychotherapy notes.

• Under no circumstances shall a contractor request a provider to submit notes defined in 45 CFR §164.501. The refusal of a provider to submit such information shall not result in the denial of a claim.

• If the medical record includes any of the information excluded from the definition of psychotherapy notes in §164.501, as stated above, the provider is responsible for extracting the information required to support that the claim is reasonable and necessary.

o Contractors must review the claim using all supporting documentation submitted by the provider.

o If the provider does not submit sufficient information to demonstrate that services were medically necessary, the claim will be denied.

• When contractors cannot make a coverage or coding determination based upon the information on the claim and its attachments, the contractors may solicit additional documentation from the provider by issuing an additional documentation request (ADR).

o Contractors must request records related to the claim(s) being reviewed.

• Documentation Requirements and Physician Supervision.

o The following components will be used to help determine whether the services provided were accurate and appropriate:

o Initial Psychiatric Evaluation/Certification.

 Upon admission, a certification by the physician must be made that the patient admitted to the PHP would require inpatient psychiatric hospitalization if the partial hospitalization services were not provided.

 The certification should identify the diagnosis and psychiatric need for the partial hospitalization.

 Partial hospitalization services must be furnished under an individualized written plan of care, established by the physician, which includes the active treatment provided through the combination of structured, intensive services identified in §1861 that are reasonable and necessary to treat the presentation of serious psychiatric symptoms and to prevent relapse or hospitalization.

o Physician Recertification Requirements.

  Signature.

• The physician recertification must be signed by a physician who is treating the patient and has knowledge of the patient’s response to treatment.

 Timing.

• The first recertification is required as of the 18th calendar day following admission to the PHP.

• Subsequent recertifications are required at intervals established by the provider, but no less frequently than every 30 days.

 Content

• The recertification must specify that the patient would otherwise require inpatient psychiatric care in the absence of continued stay in the PHP and describe the following:

• The patient’s response to the therapeutic interventions provided by the PHP.

• The patient’s psychiatric symptoms that continue to place the patient at risk of hospitalization

• Treatment goals for coordination of services to facilitate discharge from the PHP.

o Treatment Plan

 Partial hospitalization is active treatment:

• Pursuant to an individualized treatment plan.

• Prescribed and signed by a physician.

• Which identifies treatment goals.

• Describes a coordination of services.

• Is structured to meet the particular needs of the patient.

• Includes a multidisciplinary team approach to patient care.

• The treatment goals described in the treatment plan should directly address the presenting symptoms and are the basis for evaluating the patient’s response to treatment.

o Treatment goals should be designed to measure the patient’s response to active treatment.

o The plan should document ongoing efforts to restore the individual patient to a higher level of functioning that would permit discharge from the program, or reflect the continued need for the intensity of the active therapy to maintain the individual’s condition and functional level and to prevent relapse or hospitalization.

o Activities that are primarily recreational and diversionary, or provide only a level of functional support that does not treat the serious presenting psychiatric symptoms placing the patient at risk, do not qualify as partial hospitalization services.

o An individualized formal treatment plan must be signed and dated by a physician and established within 7 DAYS of admission to the program, and must include the following:

 Formulation of the patient’s status, including an assessment of the reasonable expectation that the patient will make timely and significant practical improvement in the presenting acute symptoms, as a result of the active treatment provided by the partial hospitalization program.

And

 ICD-9/DSM-IV diagnoses, including all five axes of the multiaxial assessment as described in DSM-IV, to assist in establishing the patient’s baseline functioning.

And

 Documentation listing treatment goals under the individualized plan, modalities of therapy and/or services rendered including amount, frequency and planned duration.

o The frequency of treatment plan updates is always contingent upon an individual patient’s needs.

 The treatment planning updates must be based on the physician’s periodic consultation with therapists and staff, review of medical records, and patient interviews.

o A treatment plan review or ‘team’ conference should take place a minimum of every 2 weeks to review and update treatment plan, medication changes, and patient’s response to treatment modalities.

• d.) Progress Notes. Section 1833(e) of the Social Security Act prevents Medicare from paying for services unless necessary and sufficient information is submitted that shows that services were provided and to determine the amounts due.

o A provider may submit progress notes to document the services that have been provided.

o The progress note should include a description of the nature of the treatment service, the patient’s response to the therapeutic intervention and its relation to the goals indicated in the treatment plan.

o The progress note must be written by the team member rendering the service, including the credentials of the rendering provider and must include the following:

 The type of service rendered (name of the specific psychotherapy group, educational group, etc. if applicable).

 The problem/functional deficit to be addressed during the session, and how it relates to the patient’s current condition, diagnosis, and problem/deficit identified in the treatment plan.

 The content of the therapeutic session, as well as a clear description of the intervention used to assist the patient in reaching the related treatment goal.

 The patient’s status (behavior, verbalizations, mental status) during the session.

 The patient’s response to the therapeutic intervention including benefit from the session and how it relates to progress made toward the short/long term goal in measurable and functional terms.

• Functional improvement is considered to be the patient’s increasing ability to function outside of the direction or support of a therapist and or therapeutic environment.

• Measures of functional improvement may include, but are not limited to, patient appearance, patient participation in therapy, or the patient’s performance of activities of daily living.

• See the Medicare Claims Processing Manual, Chapter 4, “Hospital Outpatient Services,” §100, for billing instructions for partial hospitalization services.

• Eligibility Criteria and Documentation Requirements can be found in the Coverage Determinations Manual.

Utilization Guidelines

• It is expected that these services would be performed as indicated by current medical literature and/or standards of practice.

• Patient progress may be small or not be measurable at each session; however a trend should be measurable presenting signs of progression or regression in changes relating to behavior, thought processes or medication management.

• When services are performed in excess of established parameters, they may be subject to review for medical necessity.

• Code 90849 (multiple family psychotherapy) is generally non-covered. Such group therapy is directed to the effect of the patient’s condition on the family and does not meet Medicare’s standards of being part of the personal service to the patient.

 

Treatment Logic

• Psychotherapy is the treatment of mental illness and behavior disturbances, in which definitive therapeutic communication attempts to alleviate the emotional disturbances, reverse or change the maladaptive patterns of behavior and encourage personality growth and behavior.

 

Sources of Information and Basis for Decision

 

American Psychiatric Association. Practice guideline for the assessment and treatment of patients with suicidal behaviors. Arlington (VA): American Psychiatric Association; 2003 Nov. 117p.

 

American Psychological Association. (2003). Guidelines for Psychological Practice with Older Adults. [On-line] http://www.apa.org/practice/Guidelines_for_Psychological_Practice_with_Older_Adults.pdf

 

American Academy of Child and Adolescent Psychiatry. (November 2004). The Continuum of Care for Children and Adolescents. [On-line] http://aacap.org/publications/factsfam/continum.htm

 

FCSO LCD28973, Psychiatric Partial Hospitalization Program, 01/01/2013. The official local coverage determination (LCD) is the version on the Medicare coverage database at www.cms.gov/medicare-coverage-database/.

 

Hanley and Belfus (2001). Jacobson: Psychiatric Secrets (2nd ed.)

 

Kaplan, H.I., Sadock, B.J., and Grebb, J.A. (2002). Kaplan and Sadock’s synopsis of psychiatry (9th ed.). Baltimore: Williams & Wilkins.

 

Evidence-Based Caregiver Interventions in Geriatric Psychiatry. Richard Schultz PhD, et al. Psychiatric Clinics of North America. December 2005. 28 (4).

 

 

AMA CPT / ADA CDT Copyright Statement

CPT codes, descriptions and other data only are copyright 2012 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Clauses Apply. Current Dental Terminology, (CDT) (including procedure codes, nomenclature, descriptors and other data contained therein) is copyright by the American Dental Association. © 2002, 2004 American Dental Association. All rights reserved. Applicable FARS/DFARS apply.

 

© Automated Clinical Guidelines, LLC 2014

 

CMS LCD L28973 Psychiatric Partial Hospitalization Program