Pre-existing conditions – E.00 Mental/Personality Disorder. Looking at this definition it says to refer to the NTDB definition that is consistent with APA DSM 5, 2013 – looking at this, it still isn’t really clear what to include. The following two are the ones we struggle with all the time. -Major Depressive disorder – if a doctor writes depression, is that sufficient? -Social Anxiety Disorder – if written as anxiety, is that enough?
This definition is very specific. Both the NTDS definition and PTOS definitions are consistent with the American Psychological Association (APA) DSM 5, 2013, and documentation of “depression” is not the same as the diagnosis of a major depressive disorder. The patient must have a diagnosis of a major depressive disorder OR received treatment for major depressive disorder in order to capture this pre-existing condition. The same is true for “anxiety.” Documentation of “anxiety” is not the same as social anxiety disorder. You will only capture this pre-existing if the patient has a diagnosis of social anxiety disorder OR there is documentation of treatment for social anxiety disorder.
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