Oklahomas DC: 03R Crosswalk

1
Oklahomas DC 0-3R Crosswalk

• Debbie Spaeth
• OHCA Behavioral Health Director

2
BH Collaborative Partners

• OHCA
• OKDHS
• OSDOE
• OSDOH
• OKIMHA
• OU Child Study Center/OUHSC

• ODMHSAS
• OJA
• OCCY
• Federation of Families
• 0-3 Providers
• APS Healthcare, Inc.

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Purpose for Crosswalk

• Claims Payment Systems require HIPAA compliant
  diagnostic code sets like the ICD-9-CM and
  DSM-IV-TR
• Zero to Three providers need a developmentally,
  relational, and clinically appropriate diagnostic
  tool and code set

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DC 0-3 Crosswalk States

• Arizona
• California
• Colorado
• Florida
• Indiana
• Maryland
• Maine
• Minnesota

• New Mexico
• Ohio
• Oklahoma
• Tennessee
• Texas
• Utah
• Washington
• Others Developing

5
Training for Clinicians?

• The Oklahoma Department of Mental Health and
  Substance Abuse and the Oklahoma Infant Mental
  Health Association have made a commitment to
  offer/support annual trainings on
• Early Screening/Assessment Tools
• DC 0-3-R
• Oklahoma DC 0-3-R Crosswalk

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Prior Authorization Process

• On the PA Request, providers will
• List the DC0-3 dx code within the Interpretive
  Summary on the request
• Continue to list the ICD-9 code in the Diagnosis
  Section

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PA Process continued

• Listing the DC0-3 dx within the Interpretive
  Summary allows the APS clinical and/or medical
  reviewer to see a clearer picture of the childs
  developmental and functional level
• The DC0-3 code will more closely relate to the
  Tx Plan goals objectives than the ICD-9 codes

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DC 0-3 Axis I Clinical Disorders
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DC 0-3 100 PTSD

• DSM 309.81 PTSD

• ICD-9
• 308.0 Predominant disturbance of emotions
• Anxiety, emotional crisis, or panic state as
  acute reaction to exceptional (gross) stress
• 308.2 Predominant psychomotor disturbance
• Agitation states or stupor as acute reaction to
  exceptional (gross) stress
• 308.3 Other acute reactions to stress
• Acute situational disturbance
• Acute stress disorder
• 309.81 Posttraumatic stress disorder
• Chronic posttraumatic stress disorder
• 309.81 Posttraumatic stress disorder NOS

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DC 0-3 150 Deprivation/Maltreatment Dis

• DSM 313.89 Reactive Attachment Disorder

• ICD-9
• 995.50 Child abuse, unspecified
• 995.51 Child/emotional/psychological abuse
• 995.52 Child neglect (nutritional)
• 995.53 Child sexual abuse
• 995.54 Child physical abuse
• Battered baby or child syndrome
• 995.59 Other child abuse and neglect
• Multiple forms of abuse

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DC 0-3 200 Disorders of Affect
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210 Prolonged Bereavement/Grief Reaction

• DSM
• V62.80 Bereavement
• 296.2 Major Dep Dis, Single Episode

• ICD-9
• 309.0 Adjustment Dis w/ Dep Mood, Grief Reaction
• 309.1 Prolonged Depressive Reaction

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DC 0-3 220 Anxiety Disorders of Infancy and
Early Childhood
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221 Separation Anxiety Disorder

• DSM
• 309.21 Separation Anxiety Disorder

• ICD-9
• 309.21 Separation Anxiety Disorder

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DC 0-3 222 Specific Phobia

• DSM
• 300.29 Specific Phobia

• ICD-9
• 300.20 Phobia, unspecified
• Anxiety-hysteria NOS
• Phobia NOS
• 300.29 Other isolated or specific phobias
• Acrophobia, animal phobias, claustrophobia, or
  fear of crowds

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DC 0-3 223 Social Anxiety Disorder (Social
Phobia)

• DSM
• 300.23 Social Phobia

• ICD-9
• 300.23 Social Phobia
• Fear of eating in public, speaking in public,
  washing in public

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DC 0-3 224 Generalized Anxiety Dis

• DSM
• 300.02 Generalized Anxiety Disorder

• ICD-9
• 300.02 Generalized Anxiety Disorder

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DC 0-3 225 Anxiety Disorder NOS

• DSM
• 300.00 Anxiety Disorder, NOS

• ICD-9
• 300.00 Anxiety State, Unspecified

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DC 0-3 230 Depression of Infancy and Early
Childhood
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DC0-3 231 Type I Major Depression

• DSM
• 296.2x Major Depressive Disorder, Single Episode
• 296.3x Major Depressive, Recurrent

• ICD-9
• 296.2x Major Depressive Disorder, Single Episode
• 296.3x Major Depressive, Recurrent
• 309.0 Adjust Disorder w/Depressed Mood
• 309.1 Prolonged Depressive Reaction

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DC 0-3 232 Type II Depressive Disorder NOS

• DSM
• 311 Depressive Disorder, NOS

• ICD-9
• 311 Depressive Disorder, Not Elsewhere Classified
• Depressive Disorder NOS,
• Depressive State NOS,
• Depression NOS
• 313.1 Misery and Unhappiness Disorder

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DC 0-3 240 Mixed Disorder of Emotional
Expressiveness

• DSM 296.90 Mood Disorder, NOS

• ICD-9
• 296.90 Other and Unspecified Mood Disorder
• 313.9 Unspecified emotional disturbance of
  childhood or adolescence
• Mental disorder of infancy, childhood, or
  adolescence, NOS

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DC 0-3 300 Adjustment Disorder

• DSM and ICD-9
• 309.0 Adjustment Disorder w/Depressed Mood
• Grief Reaction
• 309.24 Adjustment Disorder w/Anxiety
• 309.28 Adjustment Disorder w/Mixed Anxiety and
  Depressed Mood

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DC 0-3 300 Adjustment Disorder

• DSM and ICD-9
• 309.3 Adjustment Disorder w/Disturbance of
  Conduct
• Conduct Disturbance or destructiveness as
  adjustment reaction
• 309.4 Adj Dis w/Mixed Disturbance of Emotions and
  Conduct
• 309.82 Adj Reaction w/Physical Symptoms

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DC 0-3 300 Adjustment Disorder

• DSM and ICD-9
• 309.83 Adj Reaction w/Withdrawal
• Elective Mutism as Adjustment Reaction
• Hospitalism (in children), NOS
• 309.89 Adjustment Reaction, Other
• 309.9 Unspecified Adjustment Reaction
• Adaptation Reaction, NOS
• Adjustment Reaction, NOS

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DC 0-3 400 Regulation Disorders of Sensory
Processing DC0-3 410 Hypersensitive
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DC0-3 411 Type A Fearful/Cautious

• ICD-9
• 300.00 Anxiety State, Unspecified
• 300.02 Gen Anxiety Disorder
• 309.0 Adj Dis w/Dep Mood
• 309.24 Adj Dis w/Anxiety
• 309.28 Adj Dis w/Mixed Anx Dep Mood
• 309.9 Unspec Adj Dis
• 313.0 Overanxious Dis
• 315.4 Developmental Coord Dis
• Clumsiness Syndrome
• Dyspraxia Syndrome
• Specific Motor Devel Dis

• DSM
• 300.00 Anxiety Disorder, NOS
• 300.02 Gen Anxiety Disorder
• 309.0 Adj Dis w/Dep Mood
• 309.24 Adj Dis w/Anxiety
• 309.28Adj Dis w/Mixed Anx Dep Mood
• 309.9 Unspec Adj Dis

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DC0-3 412 Type B Negative Defiant

• DSM
• 309.0 Adj Dis w/Dep Mood
• 309.24 Adj Dis w/Anxiety
• 309.28Adj Dis w/ Mix Anx Dep Mood
• 309.3 Adj Dis w/Dist of Conduct
• 309.4 Adj Dis w/Mix Dis of Emot Conduct
• 309.9 Unspec Adj Dis
• 312.9 Disruptive BH Dis, NOS

• ICD-9
• 309.0 Adj Dis w/Dep Mood
• 309.24 Adj Dis w/Anxiety
• 309.28 Adj Dis w/Mixed Anx Dep Mood
• 309.3 Adj Dis w/Dist of Cond
• 309.4 Adj Dis w/Mixed Dist of Emots Cond
• 309.9 Unspec Adj Dis
• 312.9 Disr Beh Dis, NOS
• 313.81 Oppos Def Dis
• 315.4 Developmental Coord Dis
• Clumsiness Syndrome
• Dyspraxia Syndrome
• Specific Motor Devel Dis

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DC0-3 420 Hyposensitive /Under-responsive

• DSM Unspecified Adjustment Disorder
• ICD-9
• 309.9 Unspec Adj Reaction
• 313.2 Sensitivity, Shyness, Social Withd
• 313.21 Shyness Dis of Childhood
• Sensitivity reaction of child or adolescence
• 313.22 Introverted Dis or Childhood
• Social With or With reaction of Child or Adol

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DC0-3 430 Sensory Stimulation Seeking/Impulsive

• DSM
• 309.3 Adjustment Disorder of Conduct
• 309.4 Adj Dis w/Mixed Dist of Emot Cond
• 312.3x Impulse Control Disorder
• 312.9 Disruptive Behavior Disorder, NOS

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DC0-3 430 Sensory Stimulation Seeking/Impulsive

• ICD-9
• 309.3 Adjustment Disorder of Conduct
• 309.4 Adj Dis w/Mixed Dist of Emot Conduct
• 312.3 Impulse Control Disorder
• 312.9 Disruptive Behavior Disorder, NOS
• 314.01 Attention Deficit Dis w/Hyperactivity
• Combined Type
• Overactivity NOS
• Predominantly hyperactive/impulsive type
• Simple disturbance of attention w/overactivity

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DC0-3 430 Sensory Stimulation Seeking/Impulsive

• ICD-9
• 314.1 Hyperkinesis w/Developmental Delay
• Develop Dis of Hyperkinesis
• Use additional code to identify any assoc
  neurological disorder
• 314.9 Unspecified Hyperkinetic Syndrome
• Hyperkinetic reaction of child or adol NOS
• Hyperkinetic syndrome NOS

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DC 0-3500 Sleep Onset Behavior Disorders
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DC0-3 510 Sleep Onset and 520 Night Waking
Disorder (Protodyssomnia)

• ICD-9
• 307.40 Nonorganic Sleep Dis, Unspec
• 307.41 Transient Dis of Initiating or Maintaining
  Sleep
• Adjustment Insomnia
• Hyposomnia, insomnia, or sleeplessness associated
  w/intermittent emotional reactions or conflicts

35
DC0-3 510 Sleep Onset and 520 Night Waking
Disorder (Protodyssomnia)

• ICD-9
• 307.42 Persistent Disturbance of Initiating or
  Maintaining Sleep

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DC0-3 510 Sleep Onset and 520 Night Waking
Disorder (Protodyssomnia)

• DSM
• 307.45 Circadian Rhythm Sleep Disorder
• 307.46 Sleep Terror Disorder
• 307.47 Nightmare Disorder Parasomnia, NOS

• ICD-9
• 307.45 Circadian Rhythm Sleep Disorder of
  Non-Organic Origin
• 307.46 Sleep Arousal Disorder
• Night terror disorder, night terrors, sleep
  terror disorder, sleepwalking, somnambulism

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DC 0-3Feeding Behavior Disorders
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• DC 0-3
• 601 Feeding Disorder of State Regulation
• 602 Feeding Disorder of Caregiver-Infant
  Reciprocity
• 603 Infantile Anorexia
• 604 Sensory Food Aversions
• 605 Feeding Disorder Associated w/Concurrent
  Medical Condition
• 606 Feeding Disorder Associated w/Insults to the
  Gastrointestinal Tract

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• DSM ICD-9
• 307.59 Eating Disorder of Infancy, NOS
• 309.0 Adjustment Dis w/Depressed Mood
• 309.24 Adjustment Disorder w/Anxiety
• 309.28 Adjustment Disorder w/Mixed Anxiety
  Depressed Mood
• 309.3 Adj Dis w/ Disturbance of Conduct
• 309.4 Adjustment Disorder w/Mixed Disturbance of
  Emotions Conduct
• 309.9 Unspecified Adjustment Disorder

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• ICD-9
• 307.50 Eating Disorder, Unspecified
• Eating Disorder, NOS
• 307.59 Other
• Feeding disorder of infancy or early child of
  non-organic origin
• Infantile feeding disturbances or loss of
  appetite of non-organic origin
• 783.3 Feeding difficulties and mismanagement
• 779.3 Regurgitation, slow feeding, vomiting in
  newborn

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DC 0-3700 Disorders of Relating and
Communicating
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DC 0-3 710 Multisystem Developmental Disorder
(MSDD)

• DSM
• 299 Autistic Disorder
• 299.9 Pervasive Develop Disorder, NOS
• 313.9 Disorder of Infancy, Childhood or
  Adolescence, NOS

• ICD-9
• 299.0x Autistic Disorder
• Childhood autism
• Infantile psychosis
• Kanners syndrome
• 299.9x Unspecified Pervasive Dev Disorder
• Child Psychosis, NOS
• Schizophrenia, child type, NOS
• Schizophrenia syndrome of child, NOS

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DC 0-3 Axis II Relationship Classification-
Parent-Infant Rx Global Assess Scale (PIR-GAS)-
Relationship Problems Checklist
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DC 0-3 no code

• Over-involved
• Under-involved
• Anxious/Tense
• Angry/Hostile
• Verbally Abusive
• Physically Abusive
• Sexually Abusive

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• DSM
• V61.20 Parent-Child Rx Problem
• V61.21 Neglect, Physical Abuse of Child, Sexual
  Abuse of Child

• ICD-9
• V61.20 Parent-Child Problems
• 313.3 Relationship Problems
• V61.21 Counseling of Victim of Child Abuse
• V61.22 Counseling for Perpetrator of Parental
  Child Abuse

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DC 0-3Axis III Medical and Developmental
Disorders and Conditions
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Axis IV Psychosocial Stressors-Psychosocial
and Environmental Stressor Checklist
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Axis V Emotional and Environmental Stressors
Checklist-Capacities for Emotional and Social
Functioning Rating Scale-Infant Toddler Social
Emotional Assessment-Ages Stages
Questionnaires Soc Emot
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Thank you so much for your work with Oklahomas
children!

• Debbie.spaeth_at_okhca.org