3-23-17 ACBHCS Mental Health Outpatient Medi-Cal Included Dx List Numeric by ICD-10 Code
ACBHCS MH Outpatient Included M/C Dx List
ICD-10
F43.0
F43.20
F43.22
F43.21
F43.24
F43.23
F43.25
F40.00
F50.02
F50.01
F84.5
F90.2
F90.1
F90.0
F60.6
F50.89
F50.81
F31.76
F31.75
F31.31
F31.32
F31.4
F31.9
F31.5
F31.0
F31.72
F31.71
F31.9
F31.74
F31.73
F31.11
F31.12
F31.13
F31.9
F31.2
F31.9
F31.9
F31.81
F45.22
F60.3
F23
F50.2
F84.3
DSM-5 Name (except shaded italic)
Acute stress disorder
Adjustment disorders, Unspecified
Adjustment disorders, With anxiety
Adjustment disorders, With depressed mood
Adjustment disorders, With disturbance of conduct
Adjustment disorders, With mixed anxiety and depressed mood
Adjustment disorders, With mixed disturbance of emotions and conduct
Agoraphobia
Anorexia nervosa, Binge-eating/purging type
Anorexia nervosa, Restricting type
Asperger's disorder 3 (Use DSM-IV criteria & ICD-10 Code)
Attention-deficit/hyperactivity disorder, Combined presentation
Attention-deficit/hyperactivity disorder, Predominately hyperactive/impulsive presentation
Attention-deficit/hyperactivity disorder, Predominately inattentive presentation
Avoidant personality disorder
Avoidant/restrictive food intake disorder
Binge Eating disorder
Bipolar I disorder, Current or most recent episode depressed, In full remission
Bipolar I disorder, Current or most recent episode depressed, In partial remission
Bipolar I disorder, Current or most recent episode depressed, Mild
Bipolar I disorder, Current or most recent episode depressed, Moderate
Bipolar I disorder, Current or most recent episode depressed, Severe
Bipolar I disorder, Current or most recent episode depressed, Unspecified
Bipolar I disorder, Current or most recent episode depressed, With psychotic features + Severe specifier
Bipolar I disorder, Current or most recent episode hypomanic
Bipolar I disorder, Current or most recent episode hypomanic, In full remission
Bipolar I disorder, Current or most recent episode hypomanic, In partial remission
Bipolar I disorder, Current or most recent episode hypomanic, Unspecified
Bipolar I disorder, Current or most recent episode manic, In full remission
Bipolar I disorder, Current or most recent episode manic, In partial remission
Bipolar I disorder, Current or most recent episode manic, Mild
Bipolar I disorder, Current or most recent episode manic, Moderate
Bipolar I disorder, Current or most recent episode manic, Severe
Bipolar I disorder, Current or most recent episode manic, Unspecified
Bipolar I disorder, Current or most recent episode manic, With psychotic features + Severe specifier
Bipolar I disorder, Current or most recent episode unspecified
Bipolar I disorder, Current or most recent episode unspecified
Bipolar II disorder
Body dysmorphic disorder
Borderline personality disorder
Brief psychotic disorder
Bulimia nervosa
Childhood disintegrative disorder 3 (Use DSM-IV criteria & ICD-10 Code)
1
v.3.23.17
Diagnosis not in DSM-5, allowed because on DHCS included list
2
DHCS approved, but diagnosis not in DSM-IV (do not use)
3
1 of 4
10/7/16 DHCS memo approved use of these diagnoses
3-23-17 ACBHCS Mental Health Outpatient Medi-Cal Included Dx List Numeric by ICD-10 Code
ICD-10
F91.2
F91.1
F91.9
F44.4
F44.6
F44.5
F44.7
F44.6
F44.4
F44.4
F44.4
F34.0
F22
F60.7
F48.1
F34.81
F44.0
F44.1
F44.81
G25.70
F98.1
F98.1
F98.0
F42.4
F65.2
G25.9
F68.10
F65.0
F65.81
F63.0
F64.0
F64.2
F41.1
F60.4
F42.3
G24.4
F63.81
F63.2
F80.9
F33.42
F33.41
F33.0
F33.1
F33.2
DSM-5 Name (except shaded italic)
Conduct disorder, Adolescent-onset type
Conduct disorder, Childhood-onset type
Conduct disorder, Unspecified onset
Conversion disorder (functional neurological symptom disorder), With abnormal movement
Conversion disorder (functional neurological symptom disorder), With anesthesia or sensory loss
Conversion disorder (functional neurological symptom disorder), With attacks or seizures
Conversion disorder (functional neurological symptom disorder), With mixed symptoms
Conversion disorder (functional neurological symptom disorder), With special sensory symptoms
Conversion disorder (functional neurological symptom disorder), With speech symptoms
Conversion disorder (functional neurological symptom disorder), With swallowing symptoms
Conversion disorder (functional neurological symptom disorder), With weakness/paralysis
Cyclothymic disorder
Delusional disorder
Dependent personality disorder
Depersonalization/derealization disorder
Disruptive Mood Dysregulation disorder
Dissociative amnesia
Dissociative amnesia, With dissociative fugue
Dissociative identity disorder
Drug induced movement disorder, unspecified1
Encopresis
Encopresis + With constipation and overflow incontinence specifier
Enuresis
Excoriation (Skin Picking) Disorder
Exhibitionistic disorder
Extrapyramidal and movement disorder, unspecified1
Factitious disorder
Fetishistic disorder
Frotteuristic disorder
Gambling disorder
Gender dysphoria in adolescents and adults
Gender dysphoria in children
Generalized anxiety disorder
Histrionic personality disorder
Hoarding Disorder
Idiopathic orofacial dystonia1
Intermittent explosive disorder
Kleptomania
Language Disorder
Major depressive disorder, Recurrent episode, In full remission
Major depressive disorder, Recurrent episode, In partial remission
Major depressive disorder, Recurrent episode, Mild
Major depressive disorder, Recurrent episode, Moderate
Major depressive disorder, Recurrent episode, Severe
1
v.3.23.17
Diagnosis not in DSM-5, allowed because on DHCS included list
2
DHCS approved, but diagnosis not in DSM-IV (do not use)
3
2 of 4
10/7/16 DHCS memo approved use of these diagnoses
3-23-17 ACBHCS Mental Health Outpatient Medi-Cal Included Dx List Numeric by ICD-10 Code
ICD-10
F33.9
F33.9
F33.3
F32.5
F32.4
F32.0
F32.1
F32.2
F32.9
F32.3
G25.71
G25.1
F60.81
G21.0
G21.11
F42.2
F60.5
F91.3
F84.8
F41.8
F90.8
F31.89
F31.89
F32.89
F91.8
R15.9
F50.89
F42.8
F28
F45.8
F41.0
F60.0
F65.4
F34.1
F84.9
F50.89
F98.3
F43.10
F63.1
F94.1
F84.2
F98.21
F25.0
F25.1
DSM-5 Name (except shaded italic)
Major depressive disorder, Recurrent episode, Unspecified
Major depressive disorder, Recurrent episode, Unspecified
Major depressive disorder, Recurrent Episode, With psychotic features + Severe specifier
Major depressive disorder, Single episode, In full remission
Major depressive disorder, Single episode, In partial remission
Major depressive disorder, Single episode, Mild
Major depressive disorder, Single episode, Moderate
Major depressive disorder, Single episode, Severe
Major depressive disorder, Single episode, Unspecified
Major depressive disorder, Single episode, With psychotic features + Severe specifier
Medication-induced acute akathisia
Medication-induced postural tremor
Narcissistic personality disorder
Neuroleptic malignant syndrome
Neuroleptic-induced parkinsonism
Obsessive-compulsive disorder
Obsessive-compulsive personality disorder
Oppositional defiant disorder
Other pervasive developmental disorders 2 (Use DSM-IV criteria & ICD-10 Code)
Other specified anxiety disorder
Other specified attention-deficit/hyperactivity disorder
Other specified bipolar and related disorder
Other specified bipolar and related disorder + With mixed features specifier
Other specified depressive disorder
Other specified disruptive, impulse-control, and conduct disorder
Other specified elimination disorder, With fecal symptoms
Other specified feeding or eating disorder
Other specified obsessive-compulsive & related disorder
Other specified schizophrenia spectrum and other psychotic disorder
Other specified somatic symptom and related disorder
Panic disorder
Paranoid personality disorder
Pedophilic disorder
Persistent depressive disorder (dysthymia)
Pervasive developmental disorder, NOS 3 (Use DSM-IV criteria & ICD-10 Code)
Pica, in adults
Pica, in children
Posttraumatic stress disorder
Pyromania
Reactive attachment disorder
Rett's Disorder 3 (Use DSM-IV criteria & ICD-10 Code)
Rumination disorder
Schizoaffective disorder, Bipolar type
Schizoaffective disorder, Depressive type
1
v.3.23.17
Diagnosis not in DSM-5, allowed because on DHCS included list
2
DHCS approved, but diagnosis not in DSM-IV (do not use)
3
3 of 4
10/7/16 DHCS memo approved use of these diagnoses
3-23-17 ACBHCS Mental Health Outpatient Medi-Cal Included Dx List Numeric by ICD-10 Code
ICD-10
F60.1
F20.9
F20.81
F21
F94.0
F93.0
F65.51
F65.52
F80.82
F40.10
F45.1
F45.1
F40.218
F40.230
F40.231
F40.233
F40.232
F40.228
F40.298
F40.248
F98.4
G25.71
F65.1
F63.3
F41.9
F90.9
F31.9
F31.9
F31.9
F80.9
F32.9
F91.9
F44.9
R15.9
F50.9
F64.9
F42.9
F65.9
F60.9
F29
F65.3
DSM-5 Name (except shaded italic)
Schizoid personality disorder
Schizophrenia
Schizophreniform disorder
Schizotypal personality disorder
Selective mutism
Separation anxiety disorder
Sexual masochism disorder
Sexual sadism disorder
Social (Pragmatic) Communication Disorder
Social anxiety disorder (social phobia)
Somatic symptom disorder
Somatic symptom disorder + predominant pain specifier
Specific phobia, Animal
Specific phobia, Fear of blood
Specific phobia, Fear of injections and transfusions
Specific phobia, Fear of injury
Specific phobia, Fear of other medical care
Specific phobia, Natural environment
Specific phobia, Other
Specific phobia, Situational
Stereotypic movement disorder
Tardive akathisia
Transvestic disorder
Trichotillomania (hair-pulling disorder)
Unspecified anxiety disorder
Unspecified attention-deficit/hyperactivity disorder
Unspecified bipolar and related disorder
Unspecified bipolar and related disorder
Unspecified bipolar and related disorder + With mixed features specifier
Unspecified Communication Disorder
Unspecified depressive disorder
Unspecified disruptive, impulse-control, and conduct disorder
Unspecified dissociative disorder
Unspecified elimination disorder, With fecal symptoms
Unspecified feeding or eating disorder
Unspecified gender dysphoria
Unspecified obsessive-compulsive & related disorder
Unspecified paraphilic disorder
Unspecified personality disorder
Unspecified schizophrenia spectrum and other psychotic disorder
Voyeuristic disorder
1
v.3.23.17
Diagnosis not in DSM-5, allowed because on DHCS included list
2
DHCS approved, but diagnosis not in DSM-IV (do not use)
3
4 of 4
10/7/16 DHCS memo approved use of these diagnoses