Wrong diagnosis? please help me calm down

This is my first post and I'm a little freaked out right now. I just started getting help for a long standing depression problem a few months ago. I was just looking at a statement from the counselor's office and the code by my name has me really freaked. I'm hoping it's some kind of patient number and not a diagnosis code because it's for some kind of schizophrenia according to the code descriptions.

I can't find out anything more from the office until Monday but I'm really upset by this. I've had issues with depression for my entire life, with a major episode this summer that drove me to get help finally. NEVER in any of my visits has schizo anything been mentioned! I don't fit and never have any of the criteria for that disorder.

I guess what my major concern is if this is the diagnosis reported to my insurance company, how do I or can I get it corrected? I'm concerned about what's reported to my employer (very small company) and what's on my permanent file.

THe psychiatrist told me it was dysthymic depression, which is what I expected. So I don't know where this other bit came from. The other woman is see is a counselor but what technical designation she has, I don't know or what she can actually diagnose. She's never that I remember mentioned a diagnosis on her part. I'm having a pretty bad panic about this. I know I'm going to freak out until Monday when I can call the office. I'm so upset right now, I'm just shaking and don't have anyone to talk to.

Hey. If it is 'schizo' anything it will probably be 'schizo-affective' which is kinda similar to... mood disorder (e.g., depression) with... psychotic features. when you got really very depressed did you hear voices or hallucinate or something?

It could be about that...

Or it could be about... Her trying to maximise the number of sessions that you can get out of your health insurance provider...

That being said... I think it is good to talk to clinician's about that. When they *have* to code I think it is important to talk to them and negotiate (for privacy etc).

Hang in there...

do you know the precise code description?

that would help me figure it out...

Thanks for the quick answers! This is what I found. I can get a link to the specific site if you want.

ICD-9-CM Diagnosis 295.65

Schizophrenic disorders, residual type, in remission
295.65 is a specific code that can be used to specify a diagnosis

I've never heard voices or had any issues with anything but depression. I seriously know it's not that. Nothing has been mentioned in my sessions about any diagnosis, except for the dysthmia by the psych. I don't know why I'm so wigged out over this but I just can't get a grip right now.

I wonder if a number got transposed or something. 296 would be mood disorders. It's not that hard to accidentally hit a 5 instead of a 6. Try to hang in there and ask about it, ok?

sounds like a mistake.

er...

why is she using ICD-9?

mistake would be great! I'm probably making the whole thing worse because all I have to go from is my billing statement. So I don't really know she's using ICD-9, reading gets me in trouble because I don't know and am probably freaking out about nothing. Again. And it really makes no sense that would be my diagnosis. It's just a long time to spin until Monday.

It's been a crazy week, I've been pretty level the last few weeks or so but the last few days have been pretty rough. There's another thread in 'depression' that I could have written, the thread is called 'sighs' I think. I just want to feel normal for a little while at least. Or at least not like such a failure all the time.

ICD -9- CM just stands for International Classification of Diseases, 9th revision, clinical modification. I guess it just tells the insurance company that the number is from that list of classifications. ICD is used for mental and physical diseases.

check out

ICD-10 (newer version)
and
DSM-IV-TR coding.

Especially if you live in the US then you are probably looking at DSM-IV-TR coding. I don't know how the coding matches up except that they needed to sell another book on how to match the coding ROFLMAO!!!

Hrm... Seems to be the same code (wow that was hard!)...

Um... On the upside... You are in remission, well done ;-)

(my pathetic attempt at a joke)

Sounds like a mistake...

Looking at transposed numbers didn't help any... then I came up with bi-polar. I know that's not it either, in remission or not. And I'm certainly not remissing on any depression stuff right now either! Hehe, I got the funny on the second try But I am feeling a little calmer and kinda dumb for making a fuss but it really scared me to see that. I'm still worried that is what they noted and it will get back to my employer. She knows I'm seeing a psych for depression stuff, I don't want to add any more! Right now I just want to hole up until Monday and not come out. If it is wrong, can it be corrected retroactively?

I'm fairly sure that they can (and do) correct mistakes. Did you get the code off a bill she sent you? If you did then I'm fairly confident that this is a mistake because it doesn't seem to fit at all. Also... You can't be 'in remission' for something you never had.

yes, I got the code from a bill. It had the number in parenthesis just before my name, and was the only set of numbers I couldn't otherwise account for. Alexandra, thanks for your answers. I'm going to go with 'mistake' unless I find out otherwise on Monday. That way I'll at least get up tomorrow. Now I should go properly introduce myself in the 'internet travelers' section Thanks again.

Okay... Now I'm fairly sure:

1) Residual Type is when someone presents with both positive symptoms (delusions, hallucinations, formal thought disorder etc) and negative symptoms (withdrawal, a-volition etc) AND the positive symptoms have been successfully treated and the continued presence of negative symptoms is classified 'Residual Type'.

2) In Remission is then the symptoms of the previous disorder haven't been observed for the last... 2 years, I'm thinking. I'm fairly sure about that, though it might be less than 2 years if medication kicked in...

So: In order to meet criteria for that one you would need to firstly, have a diagnosis of schizophrenia, secondly have a diagnosis of residual type, and then you could get that diagnosis.

You have never been diagnosed with schizophrenia (much less residual type) and hence there is no way you could meet criteria for residual type in remission.

It has to be a mistake.

Yes my therapist gives me the wrong diagnosis all the time. First it was schizophrenia and then it was the delusional disorder and then he gave me psychotid disorder NOS. Sometimes I am not really sure if he is coming or going, and sometimes I feel that I need to start looking for a new therapist because I really do not like this man and I feel that he is regressing my psychological state back to what it was when I was 6 or 7 months old. I think that I am going to have to stop posting now and go to eat some cookies and some cameras because I am really not in a very good frame of mind right now. I think that you should go to bed because you have some really deep personal issues that you are working with right now and a good night's sleep would help you to work with them and help you to overcome your problems which are very abundant right now in the frameword of your mind.

Short update... I left a message for my therapist (why is that word hard to say?) to give me a call about the statement tomorrow. My appt is on Wednesday but I want to know what this is about before that or I'll drive myself batty. So I'll post what I find out tomorrow.

Today was a little calmer in my head. I've slept most of the day because I woke up all fevery and generally felt like crap physically. I'm guessing it has to do with my upset last night. Sleeping it off isn't the best answer but if I'm genuinely sick, it helps.

Alexandra, your last post helped. I've never been diagnosed with *anything* before now, so I'm hoping this will be easy to fix or that I'm completely wrong about the statement details and fussing over nothing. Well I'll know tomorrow at any rate.

WOW I'm sorry you are going through this anxiety! Yes, if it's a mistake it's fixable. But remember, if it isn't a mistake... that you are still who you are, and knowing any DX or insurance coding # isn't going to change what you are dealing with or how you feel. ((((hugs))) This is exactly why I wish others didn't ask to see their records etc..until they are well.!

TC! Let us know

Phillygirl, 296.20 through 296.36 are major depression, must just be a typo (I hope). Maybe you're 296.35?

I spoke with my therapist on the phone this morning. She said the number is in fact the diagnosis code but it is completely wrong. She looked up what was written on my bill and came up with the same schizophrenic bit I posted above. The psych doc's code was the one on the chart, not hers. And that wasn't what he told me at the time either, he clearly stated it is dysthymic depression that he was diagnosing. There were a few other issues with the psych doc that we talked about at my appointment last week and she got me switched to another doc in the same practice at my next visit there.

She did say the error can and will be corrected. But I'm still really concerned that now I know that's what it was, that it did get to my boss and is on my insurance files incorrectly. I'm not sure how to be certain it's corrected properly in all places. Or if I need to say something to my boss directly, he handles all the insurance stuff for the company.

Therapist was pretty shocked that it happened. She told me what her actual diagnosis of me is and that wasn't surprising. I don't usually get a statement from them, I pay my copay each time, so there's no billing involved. Fortunately, they charged me wrong the first few times. THat's how I found the error and panicked myself for the last two days. Now I'm just waiting for the director to call me and see what she has to say.

I thought going for help was going to make my life easier! Well I guess it has in that I probably wouldn't have noticed that a few months ago and would ignorantly go on being mislabeled till it bit me in the *** later.

I don't think it should get to your boss, just your insurance, they can't share any details with your boss/company. Might be able to say "mental health" if they have to explain why rates went up or something but not a specific diagnosis/problem of a specific person. If there are "a lot" of people in your company (over 20 or 30), I wouldn't even worry about that.

Well I'm really a big moron. It's also a classic example of my really overblown reactions to things that led me to therapy in the first place! Well that situation was considerably more major but really, I get nuts about what would be an ordinary occurence to most folks. And then spin myself right into a hole and beat myself up for every little thing. It's one of the things I'm really wanting to get control of at some point in my life! Dr diagnosed dysthymia, which I expected and agree with. therapist diagnosed adjustment disorder with anxiety and depression, which I didn't know anything about till then but it really does fit.

So she called me back tonight and said the whole thing was a mistake, dr's diagnosis was never schizo anything, she was geting it corrected through billing. She had me read the number back just to be sure she had it right. It didn't have a decimal point, just numbers and then she realizes it's my patient ID number. So now I feel pretty stupid for the whole thing. But in a way, I shouldn't because you'd think she'd know what shows on the statements enough to know when I first called what the info meant!

((((hugs)))) Yes, it's tough to take care of yourself, and rely upon others at times too.

As for your wishing to get control of your catastrophizing, check out the cognitive distortions listing (I think at the top of Psychotherapy Forum Index) and see if that is what you're doing and how to counter it. You can gain control...you can!

TC!