DSM-5, ICD-9/ICD-10 and QuicDoc®

There has been much confusion over the DSM-5, ICD-9, and ICD-10 codes. In order to clarify and answer questions, Dr. Arnie Schuster, President of DocuTrac, Inc. has written an article about these changes, as well as how the codes have been integrated into QuicDoc EMR Software.

The introduction of DSM-5 has been a major event and for some, a painful change, after decades of reliance on and familiarity with DSM-IV (DSM-IV-TR) codes.

DSM-5 Changes

Perhaps the most significant change with DSM-5 has been the movement away from the multi-axial system to document diagnoses – using Axis I, II, III, IV and V.  So, when making a diagnosis now, all conditions relevant to assessing and managing the patient are listed together.

While there are many other changes with DSM-5 such as planning for ICD-11, developmental and lifespan considerations, new diagnoses and the omission of diagnoses or categories of diagnoses (e.g. elimination of Schizophrenia Subtypes which are now noted as specifiers), I would like to focus on changes involving the use of codes and descriptions. 

Using ICD Codes

Early on in my career I recall submitting claims on HCFA-1500 forms and specifying DSM when entering diagnostic codes in Block 21. At the time you could choose to use DSM or ICD coding. And, in some cases, codes and their associated descriptions differed between DSM and ICD.  In some cases, adding to confusion, in DSM the same code could be used for more than one description (e.g. 300.7 for Hypochondriasis and Body Dysmorphic Disorder). This has long since changed so that payers required ICD codes to be submitted. With that change, DSM came into more conformance with ICD coding.  While that was a welcome change from the perspective of a vendor providing documentation and billing software, we were still challenged with mapping between two distinct structural approaches to making a diagnosis. On the Behavioral Health side, clinicians were making multi-axial diagnoses separating Psychiatric Disorders, Personality Disorders and Mental Retardation, and relevant Physical Conditions and Disorders. On the billing side, payers required ICD coding with primary, secondary, tertiary, etc. diagnoses.

With the elimination of the multi-axial system in DSM-5, that challenge has been eliminated. As significant as that change was there was also a shift in coding systems –  the official coding system in DSM-5 is the ICD-9.  While in some cases the name or description of the disorder may differ (e.g.  299.00 Autistic disorder (ICD-9) versus Autism Spectrum Disorder (DSM-5), the code used is the official ICD-9 code required for submission of a claim.

Moving Forward

At DocuTrac, our primary emphasis in addition to preparing for DSM-5 was the (then) upcoming October 2014 deadline for the use of ICD-10. In an eleventh hour decision by congress, the ICD-10 was delayed until Oct 2015 – to the dismay or relief of many, depending on your perspective.  In any event, DocuTrac was prepared for ICD-10 and in its latest versions of QuicDoc  and Office Therapy® we included both ICD-9 and ICD-10 coding and mapping.

We are aware that many clinicians prefer the DSM Description or Names to the ICD-9/10 Descriptions. The structure and functionality is in place in the latest version of QuicDoc to allow the user to provide the equivalent DSM name. Our next release will allow the user the option to show on print-outs, the DSM or ICD Name, if different.

As we keep up with the ever changing requirements in a very dynamic profession, DocuTrac will do it’s best to provide easy to use, intuitive, and up-to-date functionality to meet your needs. This includes the driving forces behind Meaningful Use and for many, another coding system hitting the radar – SNOMED-CT. Stay tuned for more on SNOMED later.


Dr. Arnie Schuster
President, DocuTrac, Inc.











DocuTrac will be Exhibiting at the 2014 National Council Conference

EMR Software and PM Software



Hagerstown, MD – April 8, 2014

DocuTrac, Inc. a leading developer of EMR Software and Billing Software for the behavioral health industry announced today that Jim Miller, Director of Quality Control and Compliance and Heather Painter, Director of Implementation and Training will be representing DocuTrac at the 2014 National Council Conference for Behavioral Health in Washington, DC, May 5th to the 7th.

The National Council for Behavioral Healthcare is a strong advocate for its member agencies and patients served by those agencies, promoting a legislative agenda to improve mental health and addictions treatment through access to quality, affordable treatment. The National Council coordinates the Mental Health First Aid program across the U.S. and provides nationwide technical assistance on integrating primary care and behavioral healthcare. The National Council operates the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration Center for Integrated Health Solutions.

In an effort to remain current in the shifting and converging healthcare environment, Mr. Miller and Ms. Painter hope to gain a better understanding of the new challenges that are facing their customers in the behavioral health industry. Networking with other vendors and attendees will provide insight into the role of technology in dealing with the complexities of merging medical and behavioral health care processes.

Former Secretary of State Hillary Rodham Clinton will deliver the keynote address at the Conference. She will be speaking on the Leadership Lessons regarding the challenges of change on a national level and our role and responsibilities for shaping our future.  Other keynote speakers include Senator Kelly Ayotte of New Hampshire, Linda Rosenberg, President and CEO of the National Council, Don Berwick, Former Administrator of Centers for Medicare and Medicaid Services, Tom Insel, Director of the National Institute of Mental Health, Mariel Hemingway, Patrick Kennedy, Holly Green, and Dan Tomasulo, positive psychology expert.  For more information on the conference visit the National Council Conference 2014 website.

DocuTrac develops Electronic Healthcare Records, Practice Management Software, and Data Exchange Systems for Interoperability. Their products include a certified Enterprise EMR Software System for large behavioral health and substance abuse treatment facilities, as well as Client-Server Clinical Documentation and Cloud Hosted Software for solo and small to mid-size group practitioners.

For more information about DocuTrac and their Behavioral Health Software products visit www.docutracinc.com or call 1-800-850-8510.



April 2014 Newsletter

New Versions of QuicDoc® & Office Therapy® have been Released!

We are very happy to announce the release of QuicDoc Professional EMR Software Version 9.5.5 and Office Therapy Professional Billing Software Version 11.5.0. Update Now!These major updates include the newly added DSM/ICD screen in QuicDoc, and the ability to print to the 02/12 CMS-1500 Claim Form in Office Therapy, along with many other enhancements and fixes. Visit our Updates Page for a complete list of enhancements and fixes for both programs. These latest updates are available to all users who are current on maintenance.

Click here to view videos of these the latest updates on our website.

Please call our Sales Department for the password at 800-850-8510. Both EMR Software and PM Software updates are available on our Updates Page.

Office Therapy Users: 02/12 CMS-1500 Claim Form

On January 6, 2014, providers were able to begin submitting the new 02/12 CMS-1500 Claim Form to their payers. As of April 1, 2014 only the 02/12 CMS-1500 Claim Form is to be used when submitting to your payers for processing. Please click here to access the NUCC site for detailed information regarding these changes.

Office Therapy Professional Billing Software Version 11.5.0 has been updated to accommodate the 02/12 CMS-1500 Claim Form. This form is only available in Claims Manager 5010 module of Office Therapy Professional Edition Version 11.5.0.  All claims, paper and electronic, must be filed through Claims Manager 5010. However, you may wish to contact your payers directly to verify which form to use – some payers may not be ready. If this requires you to update from your current version, please contact our Sales Department at 800-850-8510 for more information.

If you are not currently using Claims Manager 5010, we have several resources available to help you get started. We offer an extensive Help file built into Claims Manager 5010, as well as focused training webinars to show you how to correctly set up providers and generate claims (this applies to paper and electronic filing). Please visit our Calendar of Events page for dates and information.

Click here to view full newsletter.