Petition to make BPD reimbursable with health insurance companies

[Virginia_RN]

Hey all,

I am unsure of how many people are aware of this, but currently, Borderline Personality Disorder (and other PDs) are not reimbursable by health insurance companies. I do not know if The Affordable Care Act will change this, but to be make sure I created a petition on the White House's website. As of now, mental healthcare providers usually will put a different ICD code (such as Bipolar or substance abuse) to be reimbursed. It is somewhat unethical to do that, but they have to get paid for their services. It would be nice to be able to code for Borderline Personality Disorder and be reimbursed for services rendered for that diagnosis.

Coupled with the stigma of BPD, some providers may even go as far as telling a person/client they have Bipolar rather than BPD. That totally changes treatment. Bipolar is a chemical imbalance, BPD is a maladaptive behavioral pattern. The client may not even be told they have a personality disorder at all, it is just noted in their medical record.

On the flip side, people may meet the PTSD criteria and to avoid payment, they are given a diagnosis of BPD (and the ICD coded as such). I found an article on that online. It was in regards to the military.

Thank you!

[traumaRUs, MSN, APRN]

BPD is reimburseable by using the correct ICD-10 code.

301.83 - borderline personality disorder

[Virginia_RN]

I know I went on an interview and was told they must use a different code to get reimbursed. BPD was not reimbursable. I don't know where you are from, but I know MA has a parity that includes BPD as reimbursable, but MA is ahead of the rest of the country. I have also seen on insurance claims that the ICD code is anything but BPD. I just wanted to make 100% sure. :-)

*EDIT: Question--I know an ICD code for BPD exists, the issue was that if submitted, then the claim would get denied. Does anyone work in the insurance part and know for sure? If it is now reimbursable, when did it change?*

[Virginia_RN]

This is the military link (it is not health insurance reimbursement but benefits): http://www.nytimes.com/2012/02/25/us/a-military-diagnosis-personality-disorder-is-challenged.html?pagewanted=all&_r=0

This is the link to APA Axis II and insurance reimbursement issues: Personality disorders--Axis II gets short shrift and also another site that mentions this at the bottom: http://www.aapel.org/bdp/BLbpd-bipolarUS.html; again, I was also told in person of this issue about less than 2 months ago.

[traumaRUs, MSN, APRN]

I guess I don't see the issue as a person with borderline personality disorder can get insurance covered simply by using a different ICD-10 code.

[Virginia_RN]

I think that is awful that a person has to lie to the insurance company about the diagnosis to get paid. It makes it look like either they do not know what they are doing (misdiagnosis) or they are doing unethical things. I think if a person has BPD, they should be soundly allowed to have it reflected with their insurance company and to be able to get treatment and diagnostic tests completed without getting the run-around or denial.

[MunoRN, RN]

Insurance plans have always been able to limit what they cover, whether it be mental health coverage or maternity care. But now with the ACA mental health is covered, a submitted claim using the correct ICD code can't be denied just based on it being for BPD.