Standardization is a key feature in advancement in any profession. The development of standard DSM that each and every practitioner has to adhere to is key to ensuring uniformity in treatment and ensuring proper management in delivering medical services. The DSM-IV-TR is basically constituted of a number of diagnostic codes that are both clinically relevant and some that bear no relevance to clinical practice (APA, 2000). Many clinicians and medical practitioners view the three to five digit codes assigned to disorder in the DSM-IV-TR as part of their daily diagnostic approach.
Though the codes may appear to be illogical they have considerable practical consequences on the practice of medicine as standards dictate that it is only after the use of the codes will clinicians receive payment for their services and expertise. The manner in which the codes are assigned to conditions has often come under fire as no sense can be made out of the codes. The American association of Psychologists (APA) which is responsible for the development of the code is blamed for the development of a code that does not make sense. Some have even suggested that APA should develop a simple straightforward approach to the diagnostic codes.
On the other hand, APA exonerates itself from blame and attributes the coding to the International classification system (ICD)which is the official coding system used by the US governments and a number of private insurers. The codes classify medical conditions, and cause of injury and death. In fact in ICD-9-CM mental disorders are included in code 290 to 319 in the coding system that starts from one and ends at 999 (APA, 2000). When the ICD-9-CM system first came into play in the early 1970’s the codes were developed in accordance to some pre-set logical scheme.
In the earlier versions of the ICD-9-CM codes, three digit codes were considered to be of the highest order. A number of this high order codes were then divided into ten four digit categories and some even reached the five digit category. The DSM-IV-TR diagnostic codes are a result of selective perusal of ICD-9-CM system and picking codes that correspond to the DSM-IV-TR category. Therefore, all DSM-IV-TR diagnostic codes are representative of valid ICD-9-CM codes and can therefore be used in cases where ICD-9-CM codes are required. The use of ICD-9-CM is prevalent in handling insurance claims and Medicare requirements.
In fact, HIPAA requires that all clinicians use the ICD-9-CM codes for diagnosis of conditions that meet the DSM-IV-TR criteria. It should be noted that the use of DSM-IV-TR codes is not aimed at complicating the diagnosis of mental conditions rather is useful in standardizing certain data elements and thus ease electronic processing of financial and administrative healthcare transactions. In fact, DSM-IV-TR has no bearing on prescriptions that will be used and is therefore just a system put in place to ensure that the healthcare system is in line with developments in technology.
The development have been made possible by growth in technology and increase in need for better service delivery from patient which can be attributed to developments in information systems that have made the patients more aware of their rights and options. Though DSM-IV-TR and ICD-9-CM codes bear close resemblance, there are cases where different diagnosis under DSM-IV-TR codes have the same code under the ICD-9-CM. This is because the DSM-IV-TR is more specific and more definitive of specific mental conditions.