Transition to ICD-10 and DSM-5 Diagnosis List

CA-DiagnosisList (pdf)

DSM-5 Diagnosis List (Effective 10/01/2015) (pdf)Community Providers:

As you are aware, the American Psychiatric Association published the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) in 2013. This updated manual is the result of countless hours of work by thousands of experts in our field, and reflects many of the changes in thinking about mental health since the last edition was published. In an effort to reduce administrative burden, the Illinois Department of Human Services, Division of Mental Health, will implement the DSM-5 in all Rules, policies and procedures on October 1, 2015, to coincide with the federally mandated transition from the World Health Organization's International Classification of Diseases (ICD) ninth edition (ICD-9-CM) to the tenth edition (ICD-10-CM). The following is a list of the changes you can expect:

There will be new lists of diagnoses for the Serious Mental Illness (SMI) designation for adults, the Serious Emotional Disturbance (SED) designation for children and adolescents, and more broadly designated "eligible" population funded by DHS/DMH. A thorough review of the changes between DSM-IV and DSM-5 has been completed and lists created, which are attached.

All references to ICD-9 and DSM-IV within Rule 132 will be changed to ICD-10 and DSM-5. The revised Rule language is going through the JCAR process, and was published for the first 45 day comment period on June 9, 2015.

DHS/DMH has instructed the Collaborative to modify consumer registration fields to require DSM-5 diagnoses and ICD-10 codes on October 1, 2015. Further details regarding training related to these changes will be provided at a later date.

In addition, HFS is sending Provider Notices regarding the simultaneous changes being made to their systems for ICD-10 codes, which DHS/DMH providers must use to submit claims for services. Please remain attentive to all communications from HFS related to their policies and procedures for ICD-10.