Major Depressive Disorder

Major depressive disorder

According to the American Psychiatric Association, major depressive disorder can be seen in patients who have suffered a depressive episode lasting at least two weeks, as manifested by at least five of the following symptoms: depressed mood, loss of interest or pleasure in most or all activities, insomnia or hypersomnia, change in appetite or weight, psychomotor retardation or agitation, low energy, poor concentration, thoughts of worthlessness or guilt, and recurrent thoughts about death or suicidal ideation. Major depression is highly recurrent, with recurrent episodes occurring in 50% or more of patients.

Remission and recovery from major depression
Whether or not a patient is being treated for depression (e.g., counseling and/or medication), remission can be defined as a level of depressive symptoms basically indistinguishable from that in someone who has never been depressed. When reporting history of major depressive disorder, instead of coding V11.1 (i.e., personal history of affective disorders), consider using a code from the mental disorders chapter with the fifth digit for in remission.

Always remember...

When documenting major depressive disorder, it is important to document the:

- Episode (single or recurrent)

- Severity (mild, moderate, severe without psychotic features or severe with psychotic features)

- Clinical status of the current episode (in partial/full remission)

Documentation and coding tips

ICD-9-CM and ICD-10-CM both include codes for recurrent depressive disorders, as well as those in “partial or full remission.” A recurrent depressive disorder is characterized by:

- Repeated episodes of depression without any history of independent episodes of mood elevation and increased energy or mania

- At least one previous episode lasting a minimum of two weeks and separated by the current episode of at least two months

- No past hypomanic or manic episodes

- For a classification of “in remission,” the patient has had two or more depressive episodes in the past, but has been free from depressive symptoms for several months. This category can still be used if the patient is receiving treatment to reduce the risk of further episodes.

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This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and complete coding. The information presented herein is for general informational purposes only.

MEDICARE PREVENTIVE SERVICES FROM MEDICARE LEARNING NETWORK

This is a link to further information on the Medicare Preventive Services. The layout of it reminds me of a bingo card! Medicare Learning Network is the educational arm of Centers for Medicare and Medicaid Service (CMS). Remember this is further information on different types of screenings available to Medicare beneficiaries. https://www.cms.gov/Medicare/ Prevention/PrevntionGenInfo/ medicare-preventive-services/ MPS-QuickReferenceChart-1. html#AWV Disclaimer: This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and complete coding. This blog may contain references or links to statutes, regulations, or other policy materials. It is not intended to take the place of either the written law or regulations. The information presented herein is for general informational purposes only and is accurate as of the date of publication.

Table VI-4. Disease Hierarchies for the 2017 CMS-HCC Model

If the Disease Group is Listed in this column… …Then drop the Disease Group(s) listed in this column is found here : Announcement of Calendar Year (CY) 2017 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter Found at: https://www.cms.gov/Medicare/HealthPlans/MedicareAdvtgSpecRateStats/Downloads/Announcement2017.pdf P 87 If the Disease Group is Listed in this column… …Then drop the Disease Group(s) listed in this column Disclaimer: This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and complete coding. This blog may contain references or links to statutes, regulations, or other policy materials. It is not intended to take the place of either the written law or regulations. The information presented herein is for general informational purposes only and is accurate as of the dat...

Medicare Learning Network® Educational Products update

From the Thursday, May 21, 2015 MLN Connects Provider eNews from Medicare Learning Network Medicare Learning Network ® Educational Products “Chronic Care Management (CCM) Services Frequently Asked Questions (FAQs)” MLN Matters ® Article — Released MLN Matters ® Special Edition Article #SE1516 , “Chronic Care Management (CCM) Services Frequently Asked Questions (FAQs)” has been released and is now available in downloadable format. This article is designed to provide education on Medicare’s requirement for 24/7 access by individuals furnishing CCM services to the electronic care plan, rather than the entire medical record. It includes FAQs regarding billing CCM services to the Physician Fee Schedule (PFS) and Hospital Outpatient Prospective Payment System (OPPS) under CPT code 99490. “Power Mobility Pearls for the Practicing Physician” Web-Based Training Course — Released The “Power Mobility Pearls for the Practicing Physician” Web-Based Training Course (WBT) was relea...

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