Directions for Updating Diagnoses in Credible

Definitions:

1) DSM Description: The narrative description or title of the disorder. These stand apart from any code sets and can include modifiers (e.g., recurrent, severe, unspecified, etc.). This information will not be available directly in Credible.

a. Example 1, Oppositional Defiant Disorder (DSM-IV and DSM-5).

b. Example 2, Post-traumatic Stress Disorder, Chronic (DSM-IV and DSM-5)

c. Example 3, Autistic Disorder (DSM-IV) or Autism Spectrum Disorder (DSM-5)

2) ICD-9 Code: Numeric codes which are tied to specific DSM-IV and DSM-5 diagnoses. DSM-IV diagnoses have a fairly clean one-to-one match with ICD-9. However, ICD-9 codes generally do not differ based on modifiers.

a. Example 1, Oppositional Defiant Disorder (313.81)

b. Example 2, Post-traumatic Stress Disorder, Chronic (309.81)

c. Example 3, Post-traumatic Stress Disorder, Unspecified (309.81)

3) ICD-10 Code: Alphanumeric codes tied to specific DSM-IV and DSM-5 diagnoses. DSM-IV and DSM-5 diagnoses frequently do not have direct one-to-one matches to ICD-10. ICD-10 codes bring an increased level of specificity.

a. Example 1, Oppositional Defiant Disorder (F91.3)

b. Example 2, Post-traumatic Stress Disorder, Chronic (F43.12)

c. Example 3, Post-traumatic Stress Disorder, Unspecified (F43.10)

Directions for anIndividual with Current DSM-IV Diagnosis

1)Go to the appropriate individual profile screen. Click on the Diagnosis link on the individual Navigation Bar (NAV Bar):

2)You will see that the DSM-4(TR), multi-axial diagnosis will display.

3)Select “Start New Diagnosis”, in the upper right hand corner of the diagnostic screen.

4)You may receive a “warning” that will pop up to indicate that “the prior assessment contained old diagnoses that were revised in the DSM-5 and cannot be carried forward.” Click Ok.

5)If you do not get the warning above, continue.

6)You will now see the new Problem List. The multi-axial diagnosis screen was replaced by the problem list.

7)The diagnoses that now have been removed due to the warning message above will need to be reentered into Credible. Note: Please do not forget to add all applicable information that might have been lost when starting a new diagnosis. For instance, default programs, diagnosed by, SNOMED codes, etc. All that information will need to be reentered if lost.

8)If you did not get the warning message above, all the information that was previously in the last historical assessment should have carried forward, but please do make sure.

9)If you should need to review the individual’s historical history, click on History at the top right hand corner of the diagnostic screen.

10)This gives you a list of information with an upper level view of the diagnostic screen. Should you want to delve deeper, you may choose “view” under each history section to see what the detail of that diagnostic layer was. (After you’ve finished with this view, you may also Hide History.

11)Please take the time to review the individual’s ICD-9 and ICD-10 diagnoses. Please do not transfer forward diagnoses that are no longer valid. For the months prior to 10/1, MRCSB is basically dual coding (using both ICD-9 and ICD-10). Please make sure that when you are finished with the record you have both diagnoses entered.

12)To begin entering diagnoses, start by entering information into the box labeled “New” (only after Start New Diagnosis is clicked). You may enter the information in one of three ways.

  1. The DSM description. For instance: Post-Traumatic Stress Disorder
  2. The ICD-10 Code (which is the code listed in the DSM Manuel). For instance: F43.1.
  3. The ICD-9 Code. For instance: 309.81.

13)The options highlighted below are extremely important and are covered by the ICD-10/DSM training given in SABA. Please review each highlighted area. See SABA Training:

14)Notice in the above diagnostic screen there are two different looking diagnoses. Numbers 1 and 2 were more than likely imported over from the old diagnostic record that had a 1:1 match on diagnoses. Number 3 however did not have a 1:1 match and therefore shows in two distinct lines. ICD-9 is listed first and ICD-10 below. Both of these are correct.

15)Before completing the diagnostic screen, review the problem list order to make sure that all diagnoses are in the correct, numerical order. If they are not in numerical order, please either use the Resequence button or by pulling the number drop down to arrange these diagnoses in the correct order.

Attention!!! Extremely important information!

  • Unless otherwise specified (by the programs chosen in the “Default for Programs”), the primary (first) diagnosis will bill.
  • For instance, if your individual has an ID diagnosis that should bill out on all ID claims, unless that diagnosis is first in the diagnostic module or unless specified in Default for Programs, that primary listed will pull.
  • Also, at sign and submit (when completing a service) make sure that you double check the diagnosis listed. If this diagnosis is not correct, use the dropdown to fix the service, BUT also fix the diagnosis record to ensure that the next service provided by your program doesn’t causing billing issues.

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