Psychologist Diagnosed Using DSM-IV

[Granta_Omega]

He diagnosed the disorder using 299.80- Asperger's Disorder. He for some reason wouldn't go with the DSM V and even openly stated he wasn't going to use that. He also included in the report that no verbal language delays ruled out Autism.

He seemed to indicate several times implicitly that he didn't like Asperger's Disorder being included with Autism.

Are they allowed to diagnose under the DSM-IV anymore?

 

[mama_lotus]

I believe so, yes. What *may* happen, depending on the insurance company in question, is that the insurance company will call and ask for a different code number, because AS is (er, was) 299.80 and ASD is now just 299.0, there is no 299.80. But because of the 299, the autism diagnosis is there.

 

[King_Oni]

Well, considering they're actually more "guidelines" than something else, I don't see why he couldn't. I think mama_lotus does make a point, that it might depend on insurance.

On the other hand, I've been diagnosed with IV, but while I was seeing a therapist, we did talk about the DSM III even. And while he didn't use it as such for diagnostics, he was working as a psychlogist easily for the past 20+ years, so that's what he used to work with for a while, than adapting to IV and now they have to adapt for V. Some professionals don't transition that fast and that well right away (though when I saw mine it was 2011, when DSM III was way past expiration date).

Perhaps the therapist found it easier because of the seperation back in DSM IV as well.

 

[mama_lotus]

^I am glad you understood what I was trying to say in that post because I just re-read it and I am about as clear as mud. I need some coffee, I think. Anyway. There is also a big "Boycott DSM 5" movement among some psychologists, in particular surrounding the autism spectrum, so I can see a doctor doing it as a small act of rebellion, knowing that insurance companies will recode as needed.

 

[King_Oni]

There is also a big "Boycott DSM 5" movement among some psychologists, in particular surrounding the autism spectrum, so I can see a doctor doing it as a small act of rebellion, knowing that insurance companies will recode as needed.

I think it's only a matter of time until they revert it back to how it was by means of a revised edition. DSM V TR coming to your healthcare professional soon. (well, not that soon, but given it took about 10 years for DSM IV to get a revision, that might be an indication).

 

[mama_lotus]

I agree. I also think they are going to finesse Asperger's itself a bit, since the female traits are a little different, or more subtle. Maybe they will all have different names, but I think that instead of the umbrella "ASD" they will begin to recode at least gradients of the shades of gray within the spectrum.

 

[Ereth]

It's my understanding that the DSM revisions are likely going to be the subject of some debate over the next few years. So Asperger's isn't exactly going away just yet---these are meant to be guidelines, after all.

 

[dystopia]

I've asked this for clarification, as well. And from what I have been told, the DSM V does not take effect until October 2014. So, technically, we're still under the reign of the DSM IV. What I have been told, anyway.

I also agree with all the other responses.

 

[Meistersinger]

Even if the insurance company balks at the 299.80 code, your psychologist could try to bill insurance using ICD-10.


Never teach a pig to sing. It wastes your time, and annoys the pig.

 

[Granta_Omega]

He included in the medical records that lack of speech delays ruled out Autism.

However, in Autistic Disorder, it doesn't state that lack of verbal language rules it out.

I think the only part that would be difficult for a diagnosis of that under the DSM-IV is little information before the age of 3. My mom reported that I played well with my sister and learned imaginative play. Social interaction, well, I didn't interact with anyone besides family until after the age of 3, and then my social interaction issues were noticed among preschool. I did have friends, but not many in preschool.

I don't see how they really can spot much from high functioning autistic disorder prior to the age of 3 unless they go to a daycare center. My mom didn't start working until I was almost 4.

 

[Cerulean]

The ICD-9 diagnosis code (which hospitals in the US will be using until October 2015, unless Obama pushes it back again) for 299.80 does not specifically mention aspergers, it is defined as "other specified pervasive developmental disorder, current or active state". 299.00 is "autistic disorder, current or active state".

In case anyone was curious.

 

[Naturalist]

This is really interesting to me, since I am in the process of a debate about whether to go in for the complete and formal diagnosis. I don't like the DSM-V because I think there can be a vast difference in the needs and abilities of a person with Aspergers vs. classic autism. I could rant about that (actually did the other morning, debating whether to publish the essay on my blog), but in the interest of brevity will just say that I am fine with the partial diagnosis at present, as my employer is accommodating and my therapist regards me as Aspergers even with an informal diagnosis from another psychiatrist. However, the situation might be vastly different should I need to move. So I am trying to decide if I should pay for the full diagnosis now (which would be a serious financial hardship, even with good insurance), and work with a psych who is happy to use DSM-IV, or take a chance that I will need to get diagnosed later and have the autism diagnosis from a psych who insists on DSM-V.

I don't mind being identified as autistic, but I think it presents a skewed impression of my abilities, especially since many people don't understand the "spectrum" concept. Even my husband balks at it because in his mind, "autistic" is equated with "low-functioning" or "classic" autism. I recognize that in some ways, the distinctions made in the 1980's are probably responsible for that division in the public mindset, but in other ways it seems realistic: by virtue of my abilities, my needs and limitations really do differ from those of someone with "classic" autism. I would prefer to identify as Aspergers because it gives a more specific representation of who I am. (And don't we love specificity!)

And it is a good point about needing to account for differences between genders.

Thanks for pointing out the fine points with regard to filing with insurance. I had wondered about the discrepencies in the code numeration, and how they might be handled.

 

[AsheSkyler]

Oddly, I was leery of the Asperger thing and full on board with the autism thing when I started trying to figure out what precisely was going on with me. When I'd read Aspergers is now part of the autism family, I relaxed and pursued researching both. I had way too many autistic traits and I had previously been told Aspergers was nothing like autism, despite a LOT of similarities, but I also had some decidedly non-autistic traits like talking at 18 months which isn't uncommon in Aspergers. So I am high-functioning to those that only know of "classic" autism, Aspie to those familiar with the term, and to me I'm just autistic.