What Are ICD-10 Codes?
ICD stands for International Classification of Diseases, and the numeral 10 indicates that it’s the 10th revision of the original document. That original document was written in 1898. Although ICD-11 became official in 2022, virtually no countries have yet adopted it and aren’t expected to do so before 2025, so for all intents and purposes, ICD-10 is still in effect.
The ICD-10 protocol is a list of codes that are assigned to various diseases. There is also a detailed description of the disease that includes signs and symptoms, treatment options, predictions for prognosis, and other vital statistics associated with that condition.
Chiefly, the idea behind the protocol is to track the spread and effect of diseases. How they affect the population is important in combating that effect. Also, diseases might mutate, and the treatment options might change over time. When new treatments become available, it’s imperative to know if they’re effective and safe. And, if there are unpleasant side effects of the treatment, tracking the comparison between the effects of the disease vs. the side effects is also important. The healthcare system has to know if “the cure is worse than the disease.”
Additionally, keeping track of the progress of these conditions allows both field medical staff and researchers to determine the existence of, and prevalence of, comorbid conditions. Medical professionals also track patient outcomes with various treatments for each disease. Lastly, in the Byzantine world of for-profit American healthcare, there is billing and payment information associated with each code, and the healthcare companies use that collection of data to analyze profit patterns, forecast trends, and design claim systems.
ICD-10 Code F07.0: Personality Change Due to Known Physiological Condition
This code does not include personality changes that occur because of postconcussional syndrome, postencephalitic syndrome, emotional states, or mild cognitive impairment. Rather, it’s applicable limbic epilepsy, frontal lobe syndrome, organic personality disorder, postleucotomy syndrome, lobotomy syndrome, and organic pseudopsychopathic personality.
F07.0 is not a billable code under American health insurance law because of all the subcategories associated with it. Instead, insurance companies who must cover healthcare associated with personality change that occurs because of one of the underlying conditions listed above will use the codes associated with the subcategories instead. For example, the code F07.1 is for postencephalitic syndrome while F07.2 is postconcussional syndrome.
Personality Change Itself
It’s normal for people’s personality to change gradually throughout their lives. Experiences, observations, and other stimuli foment these changes. Some of them occur as defense mechanisms against trauma or other serious events with which we don’t want to associate. Some of them occur because we’ve learned things about ourselves that others find unappealing, and we decide to behave differently. We might, too, see and experience things that teach us something even without it being traumatic. For example, things that we might do and say at age 20 might seem off-putting and/or inappropriate to us at age 50.
When it comes to trauma, our reactions aren’t necessarily expected or even quantifiable. Widows and widowers, for example, sometimes turn to dark humor as a coping mechanism. Widows and widowers also sometimes become highly sexual, seeking out and having sex with many different partners. They would never have thought of having that much sex with that many partners before being widowed, but the pain of the grief is such that they sometimes experiment sexually so that they can feel something other than the grief and the pain. This, however, is not an indication of a disease or mental-health condition. Rather, it is a trauma response.
Many conditions, both physical and mental, can cause personality changes. A brain tumor is one example. Also, a rare condition known as idiopathic intracranial hypertension, which used to be known as pseudotumor cerebri, mimics certain symptoms of brain tumors. In some of these cases, the person is predisposed to develop IIH because of a congenital condition known as Factor V Leiden. Factor V Leiden is a blood disorder that actually acts as hemophilia in reverse. The person’s blood clots too much. In some cases, particularly if the person is unaware of the blood condition, someone will eat something or take a medication that is thrombolytic, causing a blood clot in the brain. Often, these are sagittal sinus clots, or similar, that restrict the flow of spinal fluid within its closed system, causing IIH. Personality change thereafter is not common, but it happens enough to be statistically significant.
Anxiety is another condition that can cause a personality change. In these cases, the change is a defense mechanism against the feelings from which the anxiety stems. For example, if a person is averse to situations with large groups of people, then that person will avoid such groups. If, in the past, the person was a gregarious sort who enjoyed interacting with groups of people, then the retreating from such that is a result of the onset of an anxiety disorder constitutes a personality change.
In some cases, the trauma that someone experiences begets post-traumatic stress disorder. PTSD manifests itself as the person relives traumatic events again and again. The person begins to fear not only the feelings associated with the event itself but also the negative reactions to that event. So, the effect of the fear multiplies itself, causing additional trauma. Such powerful fear and other negative emotions can cause a personality change as the person tries to overcome those emotions.
Bipolar disorder and schizophrenia have mood and personality changes as symptoms rather than results from a trauma or other experience. In the case of bipolar disorder, the “highs and lows” cause regular personality changes. During the manic state, the person can be driven, upbeat, happy, and productive whereas during the depressive state, the person is the exact opposite. A person suffering from schizophrenia has trouble distinguishing reality from what isn’t real. The voices that people with schizophrenia hear are an example of something that isn’t real to the outside world but seems painfully real to the person with the condition. The personality changes brought on by bipolar disorder and schizophrenia are different than those associated with anxiety, PTSD, or other experience in that they “go back and forth” fairly quickly rather than happen gradually over time.
Milder cases of personality change happen when the body produces more hormones than normal or fewer hormones than normal. Menopause and andropause are two conditions where this happens, which is in people who are assigned female at birth and assigned male at birth, respectively. The change in hormone production causes irritability and other small personality changes. These conditions are more manageable than other forms of personality change.
The treatment of personality change hinges largely on what causes the change in the first place. With bipolar disorder and schizophrenia, treatment would include medication and continuous monitoring by a psychiatrist and a family doctor. Social workers and in-home care personnel might be part of it as well. With PTSD, medication might, or might not, be required, but therapy would certainly be part of the treatment. With the combination of IIH and Factor V Leiden, there would be medication for both conditions, therapy, and a whole host of other doctors for the comorbid symptoms of both conditions. With anxiety and other conditions, therapy alone might be enough to treat the condition. Everything depends on the particular patient. No two people experience any of these conditions the same way, and no two people respond to medications or therapy the same way. The person’s care team would have to assess the person’s condition and then tailor the treatment plan accordingly.
Why Accuracy Is Important
Accuracy is crucial to the whole treatment process. Obviously, we don’t want doctors to treat the wrong condition, which could have catastrophic consequences. But, we also don’t want insurance providers to say, “No,” for no reason because of inaccuracies in the application of the ICD-10 code or codes. For example, a person with PTSD might be covered for EMDR therapy, but if the person is assigned a code for COVID-19, EMDR would likely not be covered.
People need the right treatment at the right time, and if they pay for the correct insurance coverage, then they shouldn’t have to jump through additional hoops to fix incorrectly assigned codes just not to go bankrupt.
How AutoNotes Can Help
AutoNotes is a tool that doctors, therapists, and other healthcare professionals can use to create detailed clinical notes without hours of finger-breaking work. Its chief benefit is its security. Everything a doctor does is encrypted. Both the program itself and the encryption are compliant with the Health Insurance Portability and Accountability Act of 1996.
The program works by helping the doctor create a patient profile from a wide variety of templates. Based upon the patient’s specific information, AutoNotes will create a treatment plan for each patient. Even better, as the patient’s situation changes, you can modify the profile. Thereafter, based upon the new information, AutoNotes will change the patient-care strategies.
Rather than enter paragraph after paragraph of complicated notes, all you need to do is to enter a few sentences and include a summary of patient’s diagnosis or diagnoses. AutoNotes will do the rest. You have the last word, however, because you can review the output and make any necessary changes. Once you have made sure that everything is right, then you can export the data to a .PDF and print it.
These benefits are for the patients as well as for their healthcare providers. When healthcare providers don’t have to spend inordinate amounts of energy on producing high-quality clinical notes, then they can concentrate more on their patients, thus improving the quality of the care they provide. AutoNotes is the way forward for medical professionals in the 21st century.
