Diagnosis And Definitions: ICD-10 Code For Psychosis

Psychosis is a mental disorder characterized by a significant cognitive departure from reality, often stemming from conditions like schizophrenia or bipolar disorder. Symptoms can include delusions, hallucinations, and disorganized thinking or behavior. To learn more about psychosis, it might be helpful to explore the signs and symptoms, as well as the importance of medical coding and how the disorder is annotated in the International Classification of Diseases, 10th Revision (ICD-10).

It's important to note that the ICD-10, the previous version of the diagnostic publication, has been updated to the ICD-11, the newest version. This transition reflects the evolving understanding and treatment of mental disorders, including psychosis. Staying updated with these changes can be crucial for healthcare professionals and individuals interested in learning more about mental health.  

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What is psychosis? Is it the same as schizophrenia?

Common symptoms of psychosis include: 

• Delusions: Strongly held false beliefs not based on reality
• Hallucinations: Sensory perceptions without external stimuli, like hearing voices or seeing shapes that aren't there
• Disorganized thinking or speech: Difficulty organizing thoughts or expressing them coherently
• Disorganized behavior: Acting in a way that's unpredictable or seemingly without purpose
• Difficulty concentrating or focusing: Finding it difficult to pay attention or stay on task
• Social withdrawal: Pulling away from friends, family, and social situations.
• Lack of emotional expression: Reduced or absent display of emotions, known as a flat affect
• Paranoia: Extreme distrust or suspicion of others, often with unfounded beliefs of persecution

Aside from psychotic disorders, other causes of psychosis due to a known physiological or psychological factor include the following: 

• Drug-induced psychosis
• Medical conditions like brain tumors or strokes
• Bipolar disorder
• Brief psychotic disorder
• An unspecified mental disorder
• Schizoaffective disorder
• Extreme depression (major depressive disorder with psychotic features)
• Medication misuse
• Physical or emotional symptoms due to a substance being misused
• Alzheimer's
• Thyroid issues
• Lupus
• Postpartum psychosis
• Strokes
• Vitamin deficiencies
• High stress
• Trauma
• Severe head injuries

Active psychosis is considered a mental health emergency. Reach out to crisis services in your area for support. 

What are medical codes?

Medical codes are standardized alphanumeric representations that categorize healthcare diagnoses, procedures, services, and equipment. These codes serve as a universal language in the healthcare industry, facilitating communication between healthcare providers, insurance companies, and other entities involved in patient care and billing. 

The DSM-5

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is instrumental in medical coding, providing diagnostic criteria and terminology for mental health disorders. It ensures consistency and reliability in diagnosis, aiding in effective communication among patients, clinicians, and insurance providers. 

Medical codes are established based on criteria outlined in the DSM-5, the International Classification of Diseases, the 10th Revision (ICD-10), and the ICD-11, ensuring accuracy and uniformity in healthcare documentation and reimbursement processes. The American Psychiatric Association's official website provides additional resources for patients and providers.

What is the ICD-10 for diagnosis of a mental or psychiatric disorder?

The International Classification of Diseases, 10th Revision (ICD-10)  is a diagnostic and procedure coding system endorsed by the World Health Organization (WHO). The ICD-10 system organizes healthcare information and defines universal alphanumeric codes. 

This manual serves as a cornerstone in healthcare by defining diseases, disorders, injuries, and medical procedures and translating them into standardized alphanumeric codes for billing and classification purposes. This systematic approach enables healthcare professionals worldwide to accurately record and communicate vital information about patient conditions, treatments, and medical services. 

By providing a common language for healthcare documentation, the ICD-10 facilitates data exchange, enhances patient care coordination, and supports medical research and public health initiatives on a global scale.

The ICD-10 code for psychosis symptoms

In the ICD-10-CM coding system, the code F29 is designated for diagnosing psychosis. Specifically, it refers to unspecified psychosis not due to a substance or known physiological condition. There may be an option for clinicians to declare whether the psychosis is of a depressive type or mental disorder due to known physiological factors. 

This alphanumeric code serves as a standardized identifier for healthcare professionals to document and communicate cases of psychosis for reimbursement purposes. Effective October 1st, 2023, the 2024 edition of the ICD-10-CM includes this code to ensure accurate classification and billing of mental health conditions like psychosis.

Additional information on the ICD-10 code regarding psychosis is derived from the DSM-5. These additional criteria detail crucial updates to medical coding for psychosis, including the following. 

Unspecified schizophrenia spectrum and other psychotic disorder

This category applies to presentations in which symptoms characteristic of a schizophrenia spectrum and other psychotic disorders that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the schizophrenia spectrum and other psychotic disorders class. 

The unspecified schizophrenia spectrum and other psychotic disorder category is used in situations in which the clinician chooses not to communicate the specific reason that the presentation does not meet the criteria for any particular schizophrenia spectrum or psychotic disorder. This diagnosis includes presentations with insufficient information for a more specific diagnosis, such as in emergency room settings.

Other specified schizophrenia spectrum and other psychotic disorder

The other specified schizophrenia spectrum and other psychotic disorder category applies to presentations in which symptoms characteristic of a schizophrenia spectrum disorder or psychotic disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the schizophrenia spectrum and other psychotic disorders class. This condition might also be referred to as a mental disorder (NOS), which stands for “not otherwise specified.” 

This category is used in situations in which the clinician chooses to communicate the specific reason that the presentation does not meet the criteria for any particular schizophrenia spectrum and other psychotic disorder. This process is done by recording “other specified schizophrenia spectrum and other psychotic disorder” in the patient’s record, followed by the specific reason, such as persistent auditory hallucinations.

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Support and treatment options 

Psychotic disorders and psychosis can emerge in individuals up to a year before they seek treatment, underscoring the value of reaching out to a licensed medical professional if you suspect you're experiencing symptoms associated with losing touch with reality. 

For some forms of psychosis, like those caused by enduring mental health conditions like schizophrenia or bipolar disorder, treatment may involve pharmacotherapy, including antipsychotic medication, along with non-pharmacological treatments like cognitive-behavioral therapy (CBT).

Online therapy

However, in some cases, in-person therapy can be inaccessible and unaffordable for clients. In these circumstances, online therapy through a platform like BetterHelp may be more accessible. Online therapy can offer affordability and flexibility for those contending with psychosis symptoms. In addition, clients can choose between phone, video, or live chat sessions and set a time to meet that fits their schedule. 

While online therapy may not directly target severe cases of psychosis, such as those linked to long-term schizophrenia, studies indicate that online CBT can be remarkably effective in addressing associated symptoms like anxiety and depression.