The list of billable ICD-10 codes available from the CMS gets updated annually on October 1st. We update these codes regularly, meaning that codes you previously used may become outdated. It’s important to use current codes for diagnoses, whether you file insurance claims or not.
In this guide, we'll cover:
- Do you use ICD-10 or DSM-5 descriptions?
- How can I tell if a code is billable?
- How do I update a code in a client’s file?
- How do I add a code description to a superbill?
Do you use ICD-10 or DSM-5 descriptions?
While you can find the ICD-10 codes available in your account in the DSM-5, you may find that the descriptions aren’t aligned. Because many of our customers bill insurance, we use the ICD-10 descriptions from CMS.gov.
How can I tell if a code is billable?
Every year on October 1st, the list of billable ICD-10 codes is updated. This means that diagnosis codes you previously used may become outdated. To confirm a code’s current description and to check if it’s billable:
- Navigate to the ICD-10 database
- Search for the code
- Click the ICD-10 CM Diagnosis Code
- Confirm the code has the current year and is listed as a Billable/Specific Code
How do I update a code in a client’s file?
The list of billable ICD-10 codes is updated every year on October 1st. Whether you file insurance claims or not, you’ll need to make sure that you update your client records.
Important: If you need to submit claims for any appointments that took place prior to October 1st, make sure not to include any post-October 1st appointments. If a claim has been rejected due to an invalid ICD code, you’ll need to update the client’s file, delete, and recreate the claim. Before deleting a rejected claim, download a copy and note the clearinghouse reference number.
If a diagnosis code(s) you use has been modified, you can update the client’s file. To do this:
- Navigate to the client's profile
- Click New > Diagnosis and treatment plan
-
Select the new Diagnosis Code
- Update the Description if needed
- Set the Date and time of diagnosis to a date on or after last October 1st
- Click Save
To learn more, see Diagnoses & treatment plans.
How do I add a code description to a superbill?
When billing out-of-network, some insurance payers may ask that you include a code’s description on a superbill. To do this:
- Navigate to Settings > Client billing and insurance > Client billing documents
- Scroll down to Superbills
- Check the Include diagnosis description option
- Click Save changes
Note: If a superbill was created before enabling this setting, delete it and recreate it for the change to take effect. For more on creating superbills, see Creating Superbills.
If you need to include multiple diagnosis codes on a claim or superbill, see How do I include multiple diagnoses on claims/superbills?