Subject	Disorders Subject to Mental Health Limitation
Publication	100-01 General Info

Disorders Subject to Mental Health Limitation

The term "mental, psychoneurotic, and personality disorders" is defined as the specific psychiatric conditions described in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Third Edition - Revised (DSM-III-R).

If the treatment services rendered are for both a psychiatric condition and one or more nonpsychiatric conditions, the charges are separated to apply the limitation only to the mental health charge. Normally HCPCS code and diagnoses are used. Where HCPCS code is not available on the claim, revenue code is used.

If the service is primarily on the basis of a diagnosis of Alzheimer's Disease (coded 331.0 in the International Classification of Diseases, 9th Revision) or Alzheimer's or other disorders (coded 290.XX in DSM-III-R), treatment typically represents medical management of the patient's condition (rather than psychiatric treatment) and is not subject to the limitation.