F44.81

In an effort to attempt to get some of my therapy paid for by out of network insurance coverage, I asked my therapist to write me up invoices for January and February. We briefly discussed what diagnosis codes she should use. I was overwhelmed by the conversation at the time and ultimately indifferent to the code choices. I just told her to write whatever seemed most appropriate. 

Today she gave me those invoices. Here’s a screenshot showing the codes she chose:

  
90834 is a CPT code just indicating that she sees me for individual psychotherapy. 

F44.81 is an International Classification of Diseases, 10th edition (ICD-10) code. I honestly wasn’t sure what my therapist would put for this. I figured it would be genereric, like “anxiety disorder” or “mood disorder – unspecified”, which is what Zooey always listed on her invoices, and what my psychiatrists frequently use. 

But I looked up the code and here is what it says online:

F44.81 – Dissociative Identity Disorder 

This is a specific ICD-10-CM code that can be used to specify a diagnosis. This is the American ICD-10-CM version of F44.81. Other international ICD-10 versions may differ.

Clinical Information:

  • A disorder characterized by the presence of two or more identities with distinct patterns of perception and personality which recurrently take control of the person’s behavior; this is accompanied by a retrospective gap in memory of important personal information that far exceeds ordinary forgetfulness. The changes in identity are not due to substance use or to a general medical condition.
  • A dissociative disorder in which the individual adopts two or more distinct personalities. Each personality is a fully integrated and complex unit with memories, behavior patterns and social friendships. Transition from one personality to another is sudden.

Applicable To: Multiple personality disorder. 

ICD-10-CM F44.81 is grouped within Diagnostic Related Group (MS-DRG v32.0): 883 Disorders of personality and impulse control. 

I know this is not news to you (or me), but this is the first time I have ever actually seen this on paper for myself. 
This is real. 

I really have this. I have officially (on paper I can see with my own eyes) been diagnosed with Dissociative Identity Disorder. My therapist believes me. And she believes me with enough conviction to bill my insurance using that specific code. 

Holy shit. I have a lot of feels right now. 

32 thoughts on “F44.81”

  3. nintschgo says:
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    I can so relate to that, I was also somewhere between frightened, overwhelmed, relieved and I don’t know what else when I first had my diagnoses on paper…all the best!

    Liked by 1 person

  4. atribeuntangled says:
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    I Can totally relate. There is a lot of feelings with the validation of being believed and diagnosed correctly (so many are misdiagnosed for years) and actually seeing it written down for insurance purposes. Big Stuff to process for sure on so many levels.

    Liked by 1 person

  5. e.Nice says:
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    I am glad your therapist believes you, otherwise she would be sucky and she doesn’t seem sucky. It sounds like some of the feels are good feels. Seeing a diagnosis next to my name threw me for a loop for weeks. Alternating between relief, disbelief, shame, and hopelessness like a crazy marygoround. I don’t know why, it should just be like, “oh, of course, duh, no biggy” but apparently it is a biggy for some reason.

    Liked by 2 people

    • Andi says:
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      Yeah it is jarring for whatever reason. I think because it’s just shocking to see that someone actually believes me. Because, really, to believe in the DID, you have to believe in what CAUSED the DID. So to know that she believes this horror story and understands what happened to me and SEES what’s real and the way I experience the world (as a multiple) is so validating. But it also feels a little frightening and I feel an urge to protect myself somehow. Idk, hard to explain right now.

      Liked by 1 person

  6. Jean says:
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    I also think it has something to do with the way society sees pple with different diagnoses. DID has more stigma than say, insomnia, or nicotine addiction, or even depression. It’s scary! But remember, very few people will see that diagnosis, and they won’t know you as a person, just as an account number.

    Liked by 1 person

    • Andi says:
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      Yes, absolutely. I’m not too worried, especially since it’s my wife’s company. If I switch to benefits through my own work (when I start working again) I may reconsider this, but that’s a ways away.

      Like

  7. Sirena says:
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    Very exposing and stark, seeing that diagnosis in such a clinical way. Those numbers tell nothing of the experience and the person behind them but somehow hold judgement and assumptions. But the fact that your therapist sees you and believes you is so validating and comforting.

    Liked by 1 person

  8. Rachel says:
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    This resonates to when my current therapist told me about disorganized attachment – I said Yes! And also, ah, shit! There also is something about seeing the code and words on paper that creates that visceral tightening and fear response. Don’t know exactly why, but I totally get it.

    Liked by 2 people

  10. La Quemada says:
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    I can also relate – it’s a relief to see that, yes, a professional agrees that there really is something wrong and we aren’t just making it up to get attention or exaggerating or all the other things we’ve told ourselves. And it’s a strange feeling to know that all our denial is just denial. We can’t go back to pretending there’s nothing wrong.

    Liked by 1 person

  11. La Quemada says:
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    Hi there- You haven’t posted for quite a while, but that hasn’t stopped me from thinking about you. I hope you’re doing okay, just busy or not in the mood to post.

    Related to this post – E. told me today that my insurance company called her (after a long time of leaving her alone) because I have had so many sessions. They want her to call them with a diagnosis and treatment plan and progress report. I was too afraid to ask her what she is going to tell them for a diagnosis.

    Liked by 1 person

    • Andi says:
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      Thanks for thinking of me, Q! Yeah, it can be unsettling to get an official diagnosis. Hope you two were able to talk this through (and that all works out with the insurance company).

      Like

  12. LosiLosLoco says:
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    There are codes for disorders and illnesses? What?? I didn’t even know that was a thing. Wow. Hey, your therapist believes you! That’s good. But um, you knew you had it so… maybe the feels are from the fact that it’s been completely legitimized for you to see. I don’t know. But F44.81 sounds cool without knowing what it means! 🙂 So there’s that…
    Um, how are you feeling? What kind of feels is it?

    Liked by 1 person

    • Andi says:
      Reply

      Yeah but it’s primarily for billing and public health purposes. I am not always sure I have it. It’s tricky. And I’ve spent much of my life being manipulated and told I am a liar, so I struggle to believe that I know what is real. I’m not sure what I feel. Relieved, I guess. But also scared of what it means to actually have this disorder. Idk, it’s complicated.

      Liked by 1 person

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