4901_ACM_Client Resource Guide_2023

Diagnosis Codes:

Coverage for Screens Yes/with secondary covered dx

Coverage for Confirms Yes/with secondary covered dx

Diagnosis Code

Coverage for Screens

Coverage for Confirms

Diagnosis Code

Diagnosis Description

Diagnosis Description

F11.90 OPIOID USE, UNSPECIFIED, UNCOMPLICATED

NO NO NO NO NO NO

YES YES YES YES YES YES

Z71.51 DRUG ABUSE COUNSELING AND SURVEILLANCE OF DRUG ABUSER

F11.11 OPIOID ABUSE, IN REMISSION

F16.10 HALLUCINOGEN ABUSE, UNCOMPLICATED

Z79.891 LONG TERM (CURRENT) USE OF OPIATE ANALGESIC F11.20 OPIOID DEPENDENCE, UNCOMPLICATED Z79.899 OTHER LONG TERM (CURRENT) DRUG THERAPY

YES YES YES YES YES YES YES YES YES YES YES YES YES

YES YES YES YES YES YES YES YES YES YES YES YES YES

F31.9

BIPOLAR DISORDER, UNSPECIFIED

F12.21 CANNABIS DEPENDENCE, IN REMISSION

F10.99 ALCOHOL USE, UNSPECIFIED WITH UNSPECIFIED ALCOHOL-INDUCED DISORDER

M54.50 LOW BACK PAIN, UNSPECIFIED

F15.99 OTHER STIMULANT USE, UNSPECIFIED WITH UNSPECIFIED STIMULANT-INDUCED DISORDER

NO

YES

M54.2 CERVICALGIA

M54.59 OTHER LOW BACK PAIN

F19.94 OTHER PSYCHOACTIVE SUBSTANCE USE, UNSPECIFIED WITH PSYCHOACTIVE SUBSTANCE-INDUCED MOOD DISORDER

NO

YES

F19.20 OTHER PSYCHOACTIVE SUBSTANCE DEPENDENCE, UNCOMPLICATED

M54.16 RADICULOPATHY, LUMBAR REGION

YES YES

NO NO

F20.9 F25.9

SCHIZOPHRENIA, UNSPECIFIED

M47.816 SPONDYLOSIS WITHOUT MYELOPATHY OR RADICULOPATHY, LUMBAR REGION M47.812 SPONDYLOSIS WITHOUT MYELOPATHY OR RADICULOPATHY, CERVICAL REGION M51.36 OTHER INTERVERTEBRAL DISC DEGENERATION, LUMBAR REGION

SCHIZOAFFECTIVE DISORDER, UNSPECIFIED

MAJOR DEPRESSIVE DISORDER, RECURRENT SEVERE WITHOUT PSYCHOTIC FEATURES

F33.2

NO

YES

YES YES YES YES YES YES

F34.1

DYSTHYMIC DISORDER

NO NO NO NO NO NO

M79.7 FIBROMYALGIA

F10.239 ALCOHOL DEPENDENCE WITH WITHDRAWAL, UNSPECIFIED F13.10 SEDATIVE, HYPNOTIC OR ANXIOLYTIC ABUSE, UNCOMPLICATED F15.90 OTHER STIMULANT USE, UNSPECIFIED, UNCOMPLICATED F16.20 HALLUCINOGEN DEPENDENCE, UNCOMPLICATED F19.10 OTHER PSYCHOACTIVE SUBSTANCE ABUSE, UNCOMPLICATED

M54.17 RADICULOPATHY, LUMBOSACRAL REGION

YES

YES

M47.817 SPONDYLOSIS WITHOUT MYELOPATHY OR RADICULOPATHY, LUMBOSACRAL REGION

M51.16 INTERVERTEBRAL DISC DISORDERS WITH RADICULOPATHY, LUMBAR REGION

YES YES YES YES YES YES YES YES YES YES YES YES

YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES

F20.0

PARANOID SCHIZOPHRENIA

M51.37 OTHER INTERVERTEBRAL DISC DEGENERATION, LUMBOSACRAL REGION

BIPOLAR DISORDER, CURRENT EPISODE DEPRESSED, SEVERE, WITH PSYCHOTIC FEATURES MAJOR DEPRESSIVE DISORDER, RECURRENT, MILD MAJOR DEPRESSIVE DISORDER, RECURRENT, UNSPECIFIED

F31.5

NO

YES

M79.2 NEURALGIA AND NEURITIS, UNSPECIFIED M54.51 VERTEBROGENIC LOW BACK PAIN

YES YES YES YES YES YES

F33.0 F33.9

NO NO NO NO NO NO

M25.50 PAIN IN UNSPECIFIED JOINT

M54.10 RADICULOPATHY, SITE UNSPECIFIED

F43.22 ADJUSTMENT DISORDER WITH ANXIETY

M79.18 MYALGIA, OTHER SITE

F11.220 OPIOID DEPENDENCE WITH INTOXICATION, UNCOMPLICATED

G40.909 EPILEPSY, UNSPECIFIED, NOT INTRACTABLE, WITHOUT STATUS EPILEPTICUS

F13.90 SEDATIVE, HYPNOTIC, OR ANXIOLYTIC USE, UNSPECIFIED, UNCOMPLICATED

M54.14 RADICULOPATHY, THORACIC REGION

F25.1

SCHIZOAFFECTIVE DISORDER, DEPRESSIVE TYPE

M54.18 RADICULOPATHY, SACRAL AND SACROCOCCYGEAL REGION M79.12 MYALGIA OF AUXILIARY MUSCLES, HEAD AND NECK F10.20 ALCOHOL DEPENDENCE, UNCOMPLICATED F15.20 OTHER STIMULANT DEPENDENCE, UNCOMPLICATED

F31.12 BIPOLAR DISORDER, CURRENT EPISODE MANIC WITHOUT PSYCHOTIC FEATURES, MODERATE F31.60 BIPOLAR DISORDER, CURRENT EPISODE MIXED, UNSPECIFIED

NO

YES

YES YES YES YES YES YES

NO NO NO NO NO NO

NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO

F43.12 POST-TRAUMATIC STRESS DISORDER, CHRONIC

F11.99 OPIOID USE, UNSPECIFIED WITH UNSPECIFIED OPIOID-INDUCED DISORDER

F12.20 DORSALGIA, UNSPECIFIED

F14.90 COCAINE USE, UNSPECIFIED, UNCOMPLICATED F15.11 OTHER STIMULANT ABUSE, IN REMISSION F19.11 OTHER PSYCHOACTIVE SUBSTANCE ABUSE, IN REMISSION

F14.20 COCAINE DEPENDENCE, UNCOMPLICATED F43.10 POST-TRAUMATIC STRESS DISORDER, UNSPECIFIED

F14.10 COCAINE ABUSE, UNCOMPLICATED

F13.20 SEDATIVE, HYPNOTIC OR ANXIOLYTIC DEPENDENCE, UNCOMPLICATED

F31.30 BIPOLAR DISORDER, CURRENT EPISODE DEPRESSED, MILD OR MODERATE SEVERITY, UNSPECIFIED

NO

YES

F10.21 ALCOHOL DEPENDENCE, IN REMISSION F11.21 OPIOID DEPENDENCE, IN REMISSION F15.21 OTHER STIMULANT DEPENDENCE, IN REMISSION

BIPOLAR DISORDER, CURRENT EPISODE DEPRESSED, SEVERE, WITHOUT PSYCHOTIC FEATURES

F31.4

NO

YES

YES YES

F31.77 BIPOLAR DISORDER, IN PARTIAL REMISSION, MOST RECENT EPISODE MIXED

NO NO

F60.3 F32.9

BORDERLINE PERSONALITY DISORDER

F31.89 OTHER BIPOLAR DISORDER

MAJOR DEPRESSIVE DISORDER, SINGLE EPISODE, UNSPECIFIED

MAJOR DEPRESSIVE DISORDER, RECURRENT, SEVERE WITH PSYCHOTIC SYMPTOMS

F33.3

NO

YES

F15.10 OTHER STIMULANT ABUSE, UNCOMPLICATED F12.90 CANNABIS USE, UNSPECIFIED, UNCOMPLICATED

YES YES YES YES YES

F33.40 MAJOR DEPRESSIVE DISORDER, RECURRENT, IN REMISSION, UNSPECIFIED F33.41 MAJOR DEPRESSIVE DISORDER, RECURRENT, IN PARTIAL REMISSION F33.42 MAJOR DEPRESSIVE DISORDER, RECURRENT, IN FULL REMISSION

NO NO NO NO NO

F10.11 ALCOHOL ABUSE, IN REMISSION

F19.99 OTHER PSYCHOACTIVE SUBSTANCE USE, UNSPECIFIED WITH UNSPECIFIED PSYCHOACTIVE SUBSTANCE-INDUCED DISORDER

F45.1 F60.9

UNDIFFERENTIATED SOMATOFORM DISORDER PERSONALITY DISORDER, UNSPECIFIED

F32.1 F33.1 F25.0

MAJOR DEPRESSIVE DISORDER, SINGLE EPISODE, MODERATE MAJOR DEPRESSIVE DISORDER, RECURRENT, MODERATE

LOCALIZATION-RELATED (FOCAL) (PARTIAL) IDIOPATHIC EPILEPSY AND EPILEPTIC SYNDROMES WITH SEIZURES OF LOCALIZED ONSET, NOT INTRACTABLE, WITHOUT STATUS EPILEPTICUS

SCHIZOAFFECTIVE DISORDER, BIPOLAR TYPE

G40.009

NO

YES

F31.81 BIPOLAR II DISORDER

30

31

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