Common use of ICD-10 Clause in Contracts

ICD-10. 23.1 Contractor shall use the criteria sets in the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) as the clinical tool to make diagnostic determinations. 23.2 Once a DSM diagnosis is determined, the Contractor shall determine the corresponding mental health diagnosis in the current edition of the International Classification of Diseases and Related Health Problems (ICD). Contractor shall use the ICD diagnosis code(s) to submit a claim for specialty mental health services to receive reimbursement of Federal Financial Participation (FFP) in accordance with the current covered diagnoses for reimbursement of outpatient and inpatient Medi-Cal specialty mental health services. 23.3 The lists of covered ICD diagnoses may be updated during the term of this Contract. Changes to the lists of covered ICD diagnoses do not require an amendment to this Contract and County may implement these changes per updates given by the Department of Health Care Services.