Date

On October 1, 2015, and after, MO HealthNet Division (MHD) claims will require an International Classification of Diseases (ICD), 10th Revision, and Clinical Modification/Procedure Coding Systems for codes reporting Mental, Behavioral, and Neurodevelopmental disorders. The Behavioral Health Services Manual has been updated reporting current ICD codes in the following sections.

  • Section 13.24.B diagnosis codes:
    In order to be reimbursed by MHD, the claim for the behavioral intervention must report one of the ICD codes provided in this section.
  • Section 13.25.A Partial Early Periodic Screening and Diagnosis and Treatment (EPSDT)/Healthy Children and Youth (HCY) Screen:
    The appropriate diagnosis codes for partial EPSDT/HCY screens are shown in this section. Section 13.25.A (1) shows a table demonstrating the procedure code, description, and maximum allowable reimbursement amount. 
  • Section 18.2 EPSDT/HCY screening services:
    One of the following must report as the primary diagnosis on the claim: Z00110, Z00111, Z00121 or Z00129.  
  • Section 18.3 Behavioral Health Services:
    The diagnosis code must be a valid ICD, current edition, diagnosis code and must be mental health or substance use disorder related. This does not include developmental disabilities. A table listing the ICD codes is provided in this section.

Centers for Medicare & Medicaid Services (CMS) provides many free tools and resources.