ICD-9 Code 10062: Understanding and Coding for Gravely Disabled Patients

"Gravely disabled" is a term to describe a judicial code in which a person can be involuntarily held for observation of mental conditions by a state appointed or approved peace officer. This classification means the person is a danger to himself or others. Patients deemed as gravely disabled are experiencing a psychiatric emergency and are unstable. To bill an insurance company for a patient classified as "gravely disabled," the facility must meet all requirements set by the insurance company.

Things You'll Need

• International Classification of Diseases, 9th revision (ICD-9) code book
• Current Procedural Terminology (CPT) code book
• Insurance company guidelines

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Instructions

• 1

  Obtain guidelines from the patient's insurance company for coding a patient who is gravely disabled. You may call the insurance company and request the information or check on-line. Coding guidelines can vary from insurance company to insurance company.

• 2

  Code the "gravely disabled" status as V68.2, a request for expert advice. Insurance company guidelines vary. Some insurance companies may prefer the coder to submit a code V68.9 for unspecified administrative purposes. Choose the ICD-9 code most accepted by the patient's insurance company to show the medical necessity for the patient's admission to the mental facility for observation.

• 3

  Use a Current Procedural Terminology (CPT) code(s) for inpatient care in mental facility. A code will be needed for the initial observation and a code per day the patient is held in the facility. Any medications, tests, or procedures performed during the visit should also be coded on the insurance claim form.

• 4

  Submit the claim to the insurance company for reimbursement.