Common use of MENTAL DISORDER Clause in Contracts

MENTAL DISORDER. For this agreement, a mental disorder shall be the definition in the TRICARE regulation (32 CFR 199.2): For the purposes of payment of benefits, a mental disorder is a nervous or mental condition that involves a clinically significant behavioral or psychological syndrome or pattern that is associated with a painful symptom, such as distress, and that impairs a patient’s ability to function in one or more major life activities. A Substance Use Disorder (SUD) is a mental condition that involves a maladaptive pattern of substance use leading to clinically significant impairment or distress; impaired control over substance use; social impairment; and risky use of a substance(s). Additionally, the mental disorder must be one of those conditions listed in the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) and billed with the corresponding International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), are not considered diagnosable mental disorders. “Conditions Not Attributable to a Mental Disorder,” or V codes (Z codes in the ICD-10-CM), are not considered diagnosable mental disorders. Co-occurring mental and substance use disorders are common and assessment should proceed as soon as it is possible to distinguish the substance related symptoms from other independent conditions.