If your healthcare organization is looking into ways you can expand or optimize your behavioral health program, incorporating telepsychiatry into your service offerings might be your answer.
We put together this downloadable to break down the benefits of telepsychiatry, how organizations can get started, and important considerations for your providers and patients.
At Iris Telehealth, we ensure your organization has everything it needs for a successful behavioral health program. Partnering with Iris Telehealth means your organization will have access to industry experts who will take the burden of building and optimizing an effective behavioral health program. Contact us today, and our team will work with your organization to provide effective psychiatric care and ensure the long-term care of your patients.
Iris Telehealth, a leading provider of telepsychiatry services for health systems and community health centers across the U.S., announced today that it has been recertified with the Joint Commission’s Gold Seal of Approval® for Behavioral Health Care.
This accreditation reflects the company’s commitment to providing safe, high-quality care for individuals receiving mental health services. Having first earned accreditation in 2019, Iris Telehealth is the only telepsychiatry company to achieve recertification.
“For the past nine years, our goal has been to provide high-quality virtual behavioral health services to help healthcare organizations increase access to life-saving care and improve their patient outcomes,” said Dr. Tom Milam, chief medical officer for Iris Telehealth. “This achievement is not only a testament to the hard work and dedication of our team, but also our commitment in maintaining the high standards that have been the company’s hallmark and helped propel our rapid growth.”
As a Joint Commission-accredited psychiatric medical group, Iris Telehealth holds their providers to the same patient care standards as their partner healthcare organizations, if not higher. These principles sit at the forefront of how Iris Telehealth operates their medical group, including their standards for provider selection, patient care, compliance, and regulatory oversight.
To achieve this designation, Iris Telehealth underwent an intensive review that addressed its compliance with rigorous Joint Commission performance standards related to its leadership, clinical services, the environment of care, and human resource management among others.
The Joint Commission’s standards are developed in consultation with healthcare providers, measurement experts, and patients. Informed by scientific literature and expert consensus, the standards help healthcare organizations measure, assess, and improve performance. Organizations seeking Joint Commission accreditation undergo an onsite review every three years.
About Iris Telehealth
Iris Telehealth helps healthcare organizations consistently increase access to quality mental healthcare for their patients by providing the clinicians, staff support, and knowledge to build a sustainable telepsychiatry department. With clinical grounding and emphasis on human relationships, Iris Telehealth identifies best-fit providers for each unique organization and ensures long-term commitment to meeting their partner’s needs, allowing them to provide the highest quality care to their patients and community. For more information, please visit iristelehealth.com.
Every year, 4.9 million people seeking care in the emergency department have a primary diagnosis related to a mental or behavioral health condition. With such high demand for care, helping these people get the treatment they need is crucial – for patients and hospitals alike.
However, hospitals and health systems aren’t always equipped with the right resources, leading to psychiatric boarding, unnecessary admissions, and frequent revisits. Despite these challenges, investing in telepsychiatry can help innovate your organization’s approach to mental health care.
This piece breaks down what telepsychiatry is, the benefits of using this platform in the ED, how it works, and what it looks like in action.
At Iris Telehealth, we help hospitals and health systems meet their community’s needs with high-quality, sustainable behavioral health solutions. Whether you’re facing frequent revisits or unnecessary admissions, we can help. Together, we can secure the right provider fit for your population and help meet your organization’s behavioral health goals.
Learning the ins and outs of behavioral health diagnostic coding is essential to ensuring proper coding and avoiding any significant billing issues during your patient encounter.
In this webinar, you’ll join our Regulatory Analyst, Annissa Johnson, as she shares tips and tricks for proper behavioral health diagnostic coding.
This presentation is about behavioral health diagnostic coding. The goal is to help you pick the best diagnosis so it can map to the proper code, so there aren’t any major billing issues with your patients’ stay or encounter. Hopefully, this presentation clears up some questions about picking the proper diagnosis and how it maps when it’s coded.
Tips for ICD-10 diagnostic coding for mental health
For diagnostic criteria, you want to make sure you’re consulting the Diagnostic and Statistical Manual of Mental Health Disorders, also known as the DSM. Right now, they’re on version five. They outline the diagnostic criteria for any mental health diagnosis and substance abuse diagnosis. It’s all in there. It’s very clear what the parameters are in order to diagnose a patient with those specific mental health conditions.
Remember, there are multiple severity levels in many behavioral health diagnoses. You want to make sure you include the severity level in any diagnosis where it is required. You want to look at diagnoses such as bipolar disorder, depression, major depression, and those substance abuse conditions. Those will mostly have different severity levels, mild, moderate, severe – and some of them also are coupled with psychosis, even mania.
And it’s the same way with substance abuse as well. You definitely want to make sure you’re identifying those severity levels because it can make a good difference. Mental health severity levels range from mild, moderate, and severe – and there are symptoms outlined in the DSM-5 of each. Patients have to meet certain criteria and we’ll go into that in order for you to diagnose them with those different severity levels. Always refer to the most current version of the DSM for your diagnostic criteria. We are currently on version five. I believe it took them 20 years to update from version four. It is not something that’s updated very often, but sometimes, they make changes to it on an annual basis. You want to make sure you’re using the most current version of that diagnostic material, the DSM-5.
And remember, specificity is everything. Mental health diagnostic coding strongly depends on our providers being as specific as possible. We’ll go into a few examples next.
Diagnosing major depression disorder
This is a big one. As far as your primary diagnosis, a lot of our mental health patients are diagnosed with depression, and there’s a lot of opportunity for us to do better with the way we are diagnosing and making sure we’re using those severity levels. Let’s take a closer look.
Symptoms of depression:
Depressed mood such as feelings of sadness or emptiness
Reduced interest and activities that used to be enjoyed
Sleep disturbances, not being able to sleep well or sleeping too much
Loss of energy or a significant reduction in the energy level
Difficulty concentrating, holding a conversation, paying attention, or making decisions that used to be made very easily
Suicidal thoughts or intentions
One of the two core symptoms must be present for a diagnosis of depression:
Persistent low mood and feelings of sadness with or without crying spells.
Marked lack of interest in a previously pleasurable activity.
When it’s coupled with all four of these components, that’s how you get the severe [diagnosis]. A lot of the severity levels depend on having one or two, three or four, or all. That’s why you want to make sure you are well versed with what is required for each severity level. But if you have a combination of some of these things, but it’s only hitting two boxes, then you’re going to go with the lower severity, probably mild.
And then, as you have all of them, it would be more severe. You also have the opportunity to add the psychosis or the mania in bipolarity. So, make sure you are consulting the DSM-5 for those added criteria.
When you look at that criteria again for diagnosing major depressive disorder, seven additional related symptoms are there as well.
Seven additional related symptoms of major depression disorder:
Sleep pattern disturbance
Change in appetite
Tiredness
Sluggish movement or agitation
Difficulty concentrating or solving simple everyday problems
Feelings of guilt and or worthlessness
Thoughts of death or suicide
The three levels of depression are characterized by the following:
Mild: One core symptom and usually no more than four related symptoms. So one of the core, which would’ve been one of these, and then an additional four related, which would be four of these.
Moderate: Both core symptoms are present as well as four of the more related symptoms severe.
Severe: Both core symptoms are present and most, if not all, of the related symptoms.
Important note: As you are diagnosing, doing your psychiatric evaluations or any sort of assessments you want to pick up on some of the language the patients are using to help you get to the point where you’re noticing their sleep patterns, their eating habits, whether or not they are suicidal. And of course you have other assessments if they are that you’ll need to do. But, that’s how you get to these different severity levels.
For a final diagnosis of Major Depression Disorder, the provider would select the code F32.9 for Major Depressive Disorder, Single Episode, Unspecified.
That is basic depression. If this is not the patient’s first time being diagnosed with depression, then you want to make sure you’re using a diagnosis that includes recurrent, because this would be another additional episode. It wouldn’t be a single episode because a single episode indicates that this is their first time suffering from major depression. If you’re just putting major depressive disorder or MDD, it will map to basic depression, which is F32.9. If it’s another occurrence, you want to use a code or a diagnosis that will have “recurrent episode” in the language.
Additionally, code F32.9, which is major depressive disorder, is the most mild of the mental health depression disorders. And it’s typically not a severe enough illness to justify an inpatient stay. If an inpatient is recommended, or if this person is already admitted to a behavioral health facility or to the behavioral health unit in a hospital just giving them the diagnosis of major depression sometimes isn’t enough to support them being there on an inpatient level, unless you made it a secondary diagnosis.
But as a primary diagnosis, it usually isn’t enough. You will need to add the severity level “mild,” usually you probably want to go with “moderate” or “severe.” Of course that’s if they’re meeting that criteria that we talked about previously, but you definitely want to make sure you’re adding your severity level.
The F32.9, major depressive disorder is typically seen in an outpatient setting. It’s okay if a lot of times patients come in with severe depression and once they go to the outpatient setting, it’s kind of reduced, they’re a little bit better and it goes down to a lesser severe version, which could be the major depressive disorder.
Important consideration: Without documentation of the severity level, the diagnostic code will always map to the lowest severity level. If you just put “major depressive disorder,” it’s going to code as F32.9, which is the lowest severity, which is basic depression.
If this person is meeting criteria and they have those two cores and those other symptoms as well, then you definitely want to make sure you’re using a more severe diagnostic code, giving them more severe specificity on your diagnosis for major depression.
Important tips for substance use when you’re using ICD-10 and diagnostic coding
Your diagnosis criteria will come from the DSM-5, but the codes are driven from ICD-10. Substance use disorder diagnostic coding is dependent on specification in the documentation as well. When you look at that criteria in the manual, you may understand more. Substance use disorders can be a bit more challenging to code in ICD-10. The reason for that challenge is because the DSM-5 uses a certain language which is “use disorder.” And that changed when the DSM-5 five came out in 2015, they went from “dependence” and “abuse” to “use disorder.”
With the use disorder and the DSM-5, you will add severity levels, which are the mild, moderate, severe, similar to the depression and bipolarity that we were previously discussing. However, in ICD-10, those same use disorders are still being mapped to “youth,” “abuse.” and “dependence.”
Then certain codes may or may not have the use coupled with it. Use is the lowest severity. As you look at this diagram here on the bottom right, “use” and “abuse”, are two of the lowest severity levels. Some substances do not have a use component in ICD-10, so it automatically will map to abuse. But if you are using language in your documentation of both “use” and “abuse,” either the coder or yourself will be using a code for abuse.
That’s what this diagram is outlining. If there is documentation for both of these severities “abuse” and “dependence,” then you will assign a code for dependence. You will go ahead and say, “this patient is dependent on cocaine.” Basically, it all maps to the highest severity level when there’s dual language. So unless you as the provider stick to that one thing being “abuse,” “abuse,” “abuse” throughout the documentation as you’re seeing this patient then the coder or yourself, if you end up using dependence, you will end up coding it as “this is a dependent condition.” So, be careful about that because in the DSM-5 it does clearly outline the criteria for “use,” “abuse,” and “dependence.” It’s based on the frequency of how frequently the patient is used in the substance that they’re on.
Say, the patient smokes marijuana once a week, that would usually be an abuse tendency. It wouldn’t map to a dependence for marijuana. Hopefully that makes sense. Think of it in terms of that way, it’s about the frequency. You may want to consult the DSM-5 quickly and verify what the frequency is for the substance that your patient may be using, so you know what language to consistently use on that patient’s documentation.
And then again, there’s the cheat sheet here and you always map it to the highest severity level. “Dependence” is the highest. There is “use,” “abuse,” and “dependence.” Again, severity levels are what the DSM-5 expects you to use, and that’s pretty much the expectation of behavioral health. For diagnostic criteria, you want to use the language in the DSM-5, and that is “mild,” “moderate,” and “severe.”
Important tips for substance use ICD-10 diagnostic coding
Be sure to consider the following:
Ensure the patient’s substance use frequency matches the criteria for abuse or dependence or use
Abuse diagnosis does not meet criteria typically for a payer to consider this patient needing an inpatient stay. If you just put, “A patient uses marijuana” use typically maps to abuse once it’s coded. Abuse typically is not a severe enough condition or addiction to require an inpatient stay. That’s why it’s important to use those severity levels, “mild,” “moderate,” and “severe.” If you’re going to write your diagnosis down in the language of ICD 10, then you want to make sure you’re using “use,” “abuse,” and “dependence.” Because “abuse” is not severe enough for inpatient stay.
You will see use as like a primary diagnosis, more so in an outpatient setting, that’s fine, but it wouldn’t justify an inpatient stay clinically.
Important note: If a provider were to give a final diagnosis of alcohol use disorder “abuse” you would use the code F10.10, which is the code for alcohol abuse. All these codes, all of these diagnoses have several code options because you have several different severity level options.
You have the option to add “with withdrawal,” you have the option to add “with psychosis.” Just make sure you’re consulting the DSM-5 for all of your options, like “with delirium” and all sorts of things when you’re looking at substance use. You want to make sure you’re mapping it correctly because when it’s coupled with those other factors such as psychosis or delirium or with withdrawal, those are higher severities than even dependence. So, just make sure that you are assigning those diagnoses adequately.
Common terminology to help with assigning diagnosis
Alcohol abuse: drinking in excess, but not having a physical dependence
Alcohol dependence: also known as alcoholism. A person has become dependent on alcohol and is unable to stop drinking even though alcoholism has a negative effect on a person’s health, social relationships, and non-formal daily activities
Drug abuse: taking drugs in excess, but not having a physical dependence
Drug dependence: when the, the chronic use of drugs creates a compulsion to take the drug to experience the effects of the drug or to alleviate withdrawal symptoms
Hypnotics: sleep-inducing agents
Sedatives: drugs that induce a relaxed state
Anxiolytics: drugs that relieve anxiety
Hallucinogens: substances that induce a perception of something being present that has no external cause
Nicotine: a poisonous alkaloid that high; the highly addictive compound fine found in tobacco
Inhalants: substances that are inhaled for their euphoric effect
Polysubstance drug abuse: indiscriminate use of multiple substances
There have been some updates with assigning polysubstance use and dependence. You still want to make sure that you are in somewhere in your documentation outlining the substances the patients are using, and also making sure that you are descriptive with the frequency of the substance use. In some instances, it may be more appropriate to just say, “this person is dependent on cocaine”, “this person is dependent on marijuana and other substances as well.” It’s not appropriate to say “polysubstance use, abuse, or dependence” when you are talking about a drug as well as alcohol, you will always want to outline those two separately. They’ve made recent changes to this polysubstance addiction and use and abuse. So definitely make sure you consult the DSM-5 and make sure you’re using that appropriately when it’s necessary.
Thank you for joining today and learning about some of this diagnostic coding. I hope this was helpful to you.
At Iris Telehealth, we deliver quality, sustainable behavioral health care to patients all across the country. In an effort to better support our clinicians doing the work to create a better world through healthy minds, we help ensure they have the support, flexibility, and time they need to live a life they love. If you’d like to learn more about starting a career here at Iris, you can check out our careers page.
Telepsychiatry helps connect people with the high-quality behavioral health care they need – regardless of geographic barriers, access challenges, and lack of qualified providers in a patient’s community. This virtual access to specialty care reduces the difficulty of receiving mental health care services, promotes positive outcomes, and helps patients achieve their mental health goals.
To further break down the many ways telepsychiatry supports patients and healthcare organizations across the country and enables providers to deliver high-quality care from the comfort of their homes, we put together this downloadable.
This piece covers why telepsychiatry is important, how telepsychiatry increases patient engagement, how telepsychiatry drives provider satisfaction, and the ways in which telepsychiatry improves patient and organizational outcomes.
At Iris Telehealth, we deliver quality, sustainable behavioral health care so your organization can better support the patients who need it most. At Iris, we are with you every step of the way. Together, we can help you achieve the best team fit, the right provider to help with your population’s needs, and high-quality patient care. Contact us today if you’d like to learn more about implementing telepsychiatry into your organization’s approach to behavioral health.
If you’re interested in learning more about the services we provide to healthcare organizations around the country, visit our services page or check out our FAQ.
Austin-based company ranks No. 22 among behavioral health companies appearing on the 2022 list.
Inc. magazine recently revealed that Iris Telehealth, a leading provider of telepsychiatry services for health systems and community health centers across the U.S., was included on its annual Inc. 5000 list, the most prestigious ranking of the nation’s fastest growing private companies. The ranking reflects a three-year revenue growth of 109% and marks the company’s second appearance on the annual list, having made its debut at No. 397 in 2020.
“We’re honored to once again be recognized by Inc. Magazine as one of America’s fastest growing companies,” said Andy Flanagan, CEO of Iris Telehealth. “Since our founding in 2013, our mission has been to expand high-quality virtual behavioral health services to those who need it most. This recognition is a testament to that mission and the dedication of our team in making it a reality.”
Iris Telehealth has grown exponentially over the last 18 months as healthcare organizations seek to provide timely, quality behavioral health care to their patients. The company’s combination of high-quality providers, best-in-class support, expertise in optimizing care models, and technology has enabled customers to reimagine how behavioral health services are provided across the continuum of care.
Complete results of the Inc. 5000, including company profiles and an interactive database that can be sorted by industry, region, and other criteria, can be found at https://www.inc.com/inc5000. The top 500 companies are featured in the September issue of Inc. magazine.
The companies on the 2022 Inc. 5000 have not only been successful, but also demonstrated resilience amid supply chain woes, labor shortages, and the ongoing impact of Covid-19. Among the top 500 companies on the list, the average median three-year revenue growth rate soared to 2,144%. Together, those companies added more than 68,394 jobs over the past three years.
“The accomplishment of building one of the fastest-growing companies in the U.S., in light of recent economic roadblocks, cannot be overstated,” says Scott Omelianuk, editor-in-chief of Inc. “We’re thrilled to honor the companies that have established themselves through innovation, hard work, and rising to the challenges of today.”
About Iris Telehealth
Iris Telehealth helps healthcare organizations consistently increase access to quality mental healthcare for their patients by providing the clinicians, staff support, and knowledge to build a sustainable telepsychiatry department. With clinical grounding and emphasis on human relationships, Iris Telehealth identifies best-fit providers for each unique organization and ensures long-term commitment to meeting their partner’s needs, allowing them to provide the highest quality care to their patients and community. For more information, please visit iristelehealth.com.
As a healthcare organization, finding a provider who can help meet the needs of your population and seamlessly integrate into your team’s workflow and culture is essential. But, how do you find that perfect provider match?
That’s where provider matching comes in. By working with an organization that delivers provider matching services, you can find a clinician who meets your organization’s needs and aligns with your team’s culture and values. When the right match is secured, you’ll have a provider who fills your care gaps and who your care team and patients love.
Check out this guide to learn all about the Iris Match, how provider matching works, and what makes a great provider for your population.
At Iris, we are with you every step of the way. Together, we can help you achieve the best team fit, the right provider to help with your population’s needs, and high-quality patient care. Contact us today to learn how Iris can help you secure your forever match.
At Iris Telehealth, we believe everyone deserves access to high-quality mental health services – no matter where they live or how they identify. Now more than ever, it’s essential that providers and organizations accommodate and support the mental health needs of the LGBTQIA+ population. Thankfully, telehealth can help!
Check out this infographic to learn more about the current state of LGBTQIA+ mental health, the primary challenges they face, and how telehealth can help support their needs.
With the help of telehealth, providers and organizations can provide accessible, culturally competent, and high-quality care for the LGBTQIA+ community. Contact us today to learn how you can implement an effective telepsychiatry program to help support the LGBTQIA+ community at your organization.
We know it’s tough being a mental health professional these days – and finding a job that prioritizes work-life balance, aligns with your values, and offers the flexibility you need can be a challenge.
Thankfully, that’s where telehealth comes in! For behavioral health providers, choosing a career in telehealth can help you find fulfilling and flexible work while allowing for ample time with family and friends. Plus, it opens up access to mental health care to people all across the country who might not otherwise get the support they need.
Before embarking on your telehealth journey, there are a few things to consider. In this guide, we cover:
How to find a meaningful job that aligns with your values
The benefits of telehealth and how they address burnout
How to find the right employer
A day in the life of a telemental health provider
A job hunting checklist
Guidance on finding an organization you connect with
Whether you’re looking to switch from in-person to remote work or you’re a resident exploring career opportunities, we hope this guide will help make your transition into telehealth seamless!
Healthcare IT News is an authoritative source covering the people, policy, and technology driving next-generation healthcare in the U.S. and the world. Recently, they spoke with Iris Telehealth’s CEO, Andy Flanagan, to discuss how telepsychiatry addresses provider shortages, reaches patients in rural America, and boosts patient satisfaction.
In this piece, Andy addresses how telepsychiatry serves as an optimal approach to care for hospitals and health systems. “From what we’ve seen, the most successful strategy is an integrated model where the health system, psychiatrists, therapists, psychiatric mental health nurse practitioners (PMHNPs), and other key stakeholders surround the patient in a coordinated fashion to deliver individualized, value-based care,” Andy said.
Andy believes that by enabling more streamlined behavioral health consults, providers can prevent patients from escalating to the ED – the costliest care setting for patients and providers.
