The Advocate Magazine 2022 Issue 3 | Page 13

DSM-5-TR : What Do You
Need to Know ? continued from page 12
Important Coding Changes
One significant change in DSM-5-TR that has flown under the radar is the addition of numerous Z codes . These codes were culled from ICD-10-CM ’ s extensive list of Z codes . The DSM traditionally has only included a limited number of the possible codes . For example , in DSM-5 only two Z codes are available to note any kinds of occupational problems . DSM-5-TR lists 10 codes ( e . g ., change of job , threat of job loss , stressful work schedule , discord with boss or workmates ).
Additional codes have been added for most of the sections . The plus here is that contextual issues can be noted more specifically .
The second major set of changes are revised diagnostic criteria for more than 70 disorders . While most are minor word changes for clarification , others are more significant . For example , criteria now clearly specify that all of the Autism Spectrum Disorder items related to criteria A ( social communication ) have to be met . For Persistent Depressive Disorder , criteria and text are clearer about coding both Major Depressive Disorder ( MDD ) and Persistent Depressive Disorder ( PDD ) when the MDD has occurred in the past two years .
Disorder , and the codes in the Obsessive-Compulsive and Related Disorders chapter ).
The Substance Use and Addictive Disorders chapter has also revised numerous codes , especially those that note the presence of intoxication and withdrawal for many of the substances . Also , remission status of the Substance Use Disorder can now be coded , as either early or sustained remission .
Simply put , many of the codes in your DSM-5 are now out of date . Remember , the current ICD-10-CM codes are the official ( and reimbursable ) codes .
DSM-5-TR has made a number of modifications to terminology to reflect the evolving use in the field . These disorders have been renamed to reflect more current usage :
• Intellectual Developmental Disorder replaces Intellectual Disability
• Functional Neurological Disorder replaces Conversion Disorder
• Olfactory Reference Disorder replaces Jikoshu-Kyofu
Olfactory Reference Disorder ( e . g ., preoccupied by the belief of emitting a foul odor ) is listed as an example of an Other Specified Obsessive-Compulsive and Related Disorder .
continued on page 14
There are also changes to specifiers for many of the disorders . For example , a new severity specifier is now included for a manic episode . Many of the MDD specifiers that are also listed with PDD in DSM-5 have been dropped for PDD ( e . g ., melancholic features , mixed features , peripartum onset ) in DSM-5-TR . Adjustment Disorders have a new course specifier : Acute ( symptoms less than six months ) or Persistent ( symptoms greater than six months ).
As touched on above , there are numerous important code changes throughout the manual . In addition to the updated ICD-10-CM codes implemented since 2013 , DSM-5-TR includes more than 50 additional code changes .
The most significant code changes have occurred for the new disorders added in DSM-5 ( e . g ., Disruptive Mood Dysregulation Disorder , Premenstrual Dysphoric
Which Version Is Better — Print or eBook ?
Before you decide , consider the pluses and minuses of each format . If you buy the hard copy , you have a handy book that you can pull off the shelf . I have put numerous notes and diagnostic information in the margins and have it tagged so I can easily go to any chapter .
The bad news ? Well , remember those yearly updates ? That means that by October of this year , new coding updates will be released for ICD that will need to be edited in your new manual . Though these are typically very minor , the changes nonetheless add up over time .
The ebook , on the other hand , is a living document , and it updates automatically . ( Already , there have been a few code changes that have been posted !) The downside , however , is that it can be cumbersome to pull up and difficult to personalize with notations .
Before you purchase your copy , you may want to look over the manual by checking it out from one of the online libraries .
The Advocate Magazine 2022 , Issue # 3 American Mental Health Counselors Association ( AMHCA ) www . amhca . org 13