Dear DMH Providers,
A Communication Alert disseminated to providers on June 26th 2015 contained an attachment that provided the Illinois DHS Division of Mental Health DSM-V/ICD-10 Diagnosis List that will become effective October 1, 2015. DMH providers who maintain their own management information systems will need to update their registration file layout to be able to submit these diagnoses using the batch registration submission process, as the new DSM-V/ICD-10 codes require a different reporting format.
Please find attached the Batch Registration Submission guide which contains the updated registration file layout. As you will see, all new diagnostic related fields have been added to the end of the current file layout to capture this information; thus you will not have to modify current fields that capture DSM-IV-TR/ICD-9 diagnoses. When reviewing the updated guide, you will see a notation stating that information regarding the diagnostic categories for DSM-V/ICD-10 is "under construction". As you probably know, some DSM-V/ICD-10 diagnoses can be classified in more than 1 category. Reporting the diagnostic category in addition to the specific diagnostic code will provide the context for the diagnosis provided. The Collaborative is in the process of finalizing the diagnostic categories, and this information will be disseminated ASAP in the form of an updated batch registration guide. Please note that this will not necessitate any additional changes to the file layout. It will simply provide the valid categories that may be selected for the specific corresponding DSM-V/ICD-10 diagnostic codes.
The Collaborative is also in the process of updating the screen formats for registrations, service authorization requests and other forms requiring the submission of diagnostic information through ProviderConnect. As with batch registration submission, DSM-V and ICD-10 diagnoses for these applications must be utilized on or after October 1, 2015 as well.
As a reminder, registrations using the batch registration process or registrations submitted via ProviderConnect with registration dates prior to October 1, 2015 will need to continue to have diagnoses based on the ICD-9 or DSM-IV-TR diagnostic taxonomies. This is consistent with CMMS and HFS rules for claims submission. DSM-5/ICD-10 codes should only be submitted for registrations and clinical authorizations that are submitted on or after October 1st 2015.
Please note that no modification has been made with regard to the reporting of the Global Assessment of Functioning (GAF) and the Childrens' Global Assessment Scale (CGAS) scores. The DMH will continue to require these assessments as part of the DMH eligibility criteria until further notice.
If questions regarding the updated file layout, please contact the Illinois Mental Health Collaborative EDI Help Desk. The telephone number is: (888) 247-9311. If questions regarding DMH policy, as always, please contact your DMH regional contract manager.
Thank you for your attention to this matter.
Mary E. Smith, Ph.D.
Decision Support, Research and Evaluation
Division of Mental Health
Illinois Department of Human Services
401 South Clinton, 2nd Floor (New Address Effective 4/7/2015)
Chicago, Illinois 60607