Autism Spectrum Disorder: Five Times the Codes in ICD-10
Written by Wilbur Lo, MD, CDIP, CCA
According to the National Institute of Mental Health, Autism Spectrum Disorder (ASD) is characterized by a wide range of symptoms and levels of impairment or disability that are typically recognized during the first two years of life. ASD is a complex clinical diagnosis and includes deficits in social communication and social interaction, as well as restricted, repetitive patterns of behavior, interests, or activities. The symptoms will cause significant impairment in social, occupational or other important areas of functioning.
This article will focus on the importance of properly documenting ASD, with respect to the ICD-10 code set and to the Department of Health and Human Services’ Hierarchical Condition Categories (HHS-HCCs) under the Affordable Care Act (ACA).
According to the Centers for Disease Control and Prevention, there is an increased prevalence of ASD. In 2000, ASD affected one in 150 children, compared to affecting one in 68 children in 2010. The estimated costs are between $17,000 and $21,000 more each year to care for a child with ASD, compared to a child without ASD. In 2011, the estimated total societal costs were over $9 billion to care for children with ASD—if these costs are extrapolated to 2014 or 2015, they would be astronomical.
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