PROBLEM LIST (FULL)
[textarea] DSM IV TR Axis I -- Axis II -- Axis III -- Axis IV -- [/textarea] [textarea] Z55 – Problems related to education and literacy Z56 – Problems related to employment and unemployment Z57 – Occupational exposure to risk factors Z59 – Problems related to housing and economic circumstances Z58 – Problems related to physical environment (excluding occupational exposure) Z59 – Problems related to housing and economic circumstances Z60 – Problems related to social environment Z62 – Problems related to upbringing Z63 – Other problems related to primary support group, including family circumstances Z64 – Problems related to certain psychosocial circumstances Z65 – Problems related to other psychosocial circumstances [/textarea] ICD-10-CM Code Category Problems/Risk Factors Included in Category [textarea] Z55 – Problems related to education & literacy Illiteracy, schooling unavailable, underachievement in school, educational maladjustment & discord w/ teachers & classmates.[/textarea] [textarea]Z56 – Problems related to employment & unemployment Unemployment, change of job, threat of job loss, stressful work schedule, discord w/ boss & workmates, uncongenial work environment, sexual harassment on job, & military deployment status.[/textarea] [textarea]Z57 – Occupational exposure to risk factors Occupational exposure to noise, radiation, dust, environmental tobacco smoke, toxic agents in agriculture, toxic agents in other industries, extreme temperature, & vibration.[/textarea] [textarea]Z59 – Problems related to housing & economic Homelessness, inadequate housing, discord w/ neighbors, lodgers & landlord, problems related to living in residential institutions, lack of adequate food & safe drinking water, extreme poverty, low income, insufficient social insurance & welfare support.[/textarea] [textarea]Z60 – Problems related to social environment Adjustment to life-cycle transitions, living alone, acculturation difficulty, social exclusion & rejection, target of adverse discrimination & persecution.[/textarea] [textarea]Z62 – Problems related to upbringing Inadequate parental supervision & control, parental overprotection, upbringing away from parents, child in welfare custody, institutional upbringing, hostility towards & scapegoating of child, inappropriate excessive parental pressure, personal history of abuse in childhood, personal history of neglect in childhood,[/textarea] [textarea]Z62.819 Personal history of unspecified abuse in childhood, Parent-child conflict, & sibling rivalry.[/textarea] [textarea]Z63 – Other problems related to primary support group, including family Absence of family member, disappearance & death of family member, disruption of family by separation & divorce, dependent relative needing care at home, stressful life events affecting family & household, stress on family due to return of family member from military deployment, alcoholism & drug addiction in family.[/textarea] [textarea]Z64 – Problems related to certain psychosocial circumstances[/textarea] Unwanted pregnancy, multiparity, & discord w/ counselors. [textarea]Z65 – Problems related to other psychosocial Conviction in civil & criminal proceedings without imprisonment, imprisonment & other incarceration, release from prison, other legal circumstances, victim of crime & terrorism, & exposure to disaster, war & other hostilities. [/textarea] Psychosocial Factors: ?? [textarea name="variable_1" default=" Endorsed/Discussed Following Problems"] [checkbox name="variable_1" value="Ongoing Medical Problems Recorded|Ongoing Medical Problems Not Recorded"] Medical Problems [checklist name="variable_1" value="Abdominal Pain|Allergic Reaction |Asthma|Bone / Joint Problems|Chronic Illness|Chronic Pain|Cold/Cough & Runny Nose|Conjunctivitis|Constipation|Cough|Diarrhea|Earache"] Social [checklist name="variable_1" value=""] Diagnosis [checklist name="variable_1" value=" Attention-Deficit / Hyperactivity Disorder NOS |Acute Stress Disorder |Addiction|Adjustment Disorder W/ Anxiety |Adjustment Disorder W/ Depressed Mood Agoraphobia Without History Of Panic Disorder |Bipolar Disorder|Borderline Personality Disorder |"] [textarea name="variable_1" default="Barriers to Tx"] [textarea name="variable_1" default="Aggravating Factors"] [textarea name="variable_1" default="Attempted Interventions & Response"] [textarea name="variable_1" default="How Is Life Affected By This Issue"] bx & Physical Concerns [textarea]Abandonment/Rejection Issues Abuse Abuse/Trauma Academic Problem Adult Antisocial Bx Adult Suicidal Ideation Anger Management Anger/Aggression Anger/Anger Management Anxiety Assertiveness Attachment/Bonding Beacon Emotional Problems List Becoming Easily Annoyed / Irritable bx bx Issues Bereavement/Grief/Loss Body Image Boundaries Bx Problems Can’t Control What / How Much Eat Career/Work Concerns Chalazion Change In Fam Composition, Socio-Economic Status, Lifestyle Chaotic Home Environment Chemical Dependence Childhood Trauma Circumstantial/Situational/Adjustment Concerns Cognitive Impairment Compulsive Bx Computer Addiction Conflict/Conflict Resolution Court Ordered/Coerced Crisis Denies At Time Of Intake Dependency Depression Displays Significant Psychological &// Physiological Distress Resulting From Internal & External Clues That Are Reminiscent Of Traumatic Event Does Not Know What Might Be Causing Problem Drug Allergies Dysfunctional Interpersonal Relationships Eating Disorder Eating Issues/Food/Appetite [/textarea] [textarea] Educational Problem Emotion Regulation Emotional Concerns Emotional Problems Employment Problems Environment Environmental Needs Environmental Stressors Evidenced By Sadness/Low Mood (Daily) Failure To Verbalize Emotions & Express Needs[/textarea] [textarea] Family Conflict Family Problems Feeling Bad About Self—/ Feeling Like Failure / Have Let Self / Family Down Feeling Down, Depressed / Hopeless Feeling Nervous, Anxious, On Edge / Worrying Lot About Differen Tthings Feeling Tired / Having Little Energy Fever Financial / Money Financial Problems Financial Stress Gambling Problems[/textarea] [textarea] Gastroenteritis Gord Grief Grief/Bereavement Grief/Loss Grief/Loss Unresolved Has Been Exposed To Traumatic Event Involving Actual / Perceived Threat Of Death / Serious Injury Having Anxiety Attack—Suddenly Feeling Fear / Panic Headache Health Care Costs Healthy Bx [/textarea] [textarea] Heart Valve Problems Hormone-Related Problems Immunizations Utd Impairment In Concentration (Daily) Inability To Complete Daily Tasks Infidelity Interpersonal Conflict Interpersonal Relationship Problems Intimacy Intimate Relationship Conflicts/Concerns Isolative Issues Related To Coping Skills/Abilities [/textarea] [textarea] Lack Of Close Relationships Legal Conflicts Legal Problem Lgbtq Issues Life Decisions Limited Access To Limited Economic/Financial Means Limited Support System Loneliness Longer Able To See Client Low Self-Esteem Low Wages Major Illness Making Self Vomit Mania Marital / Couple Relationship Issues Marriage/Spouse/Divorce [/textarea] [textarea] Medical History Changes; Medical Issues Miss Verbal/Social Cues Missing / Being Late For Work, School / Other Activities Because Were Drinking / Hung Over Moving / Speaking So Slowly That Others Notice;/ Opposite—Being So Fidgety / Restless Have Beenmoving Around Lot More Than Usual Muscle Tension, Aches / Soreness Nasal Congestion None Identified At Time Of Intake Ocd Oral Intake Other Overweight Panic / Agoraphobia Paranoia Parenting Parenting Problems Parenting/ Child bx Issues Peer & Intimate Relationship Problems Peer/Colleague Problems/Challenges Perception Of Problem Personal Growth Personal Problems Physical [/textarea] [textarea] Poor Appetite / Overeating Post Traumatic Stress Disorder Postpartum Depression/Women's Concerns Poverty Precipitants Present Medications; Previous Provider Problems Indicated Problems W Peers/Roommate Problems W/ Pornography Psychosocial Psychosocial Stressors Ptsd Pyschosocial Factors Rash Recent Stressor Relational/Social Difficulties Relationship Relationship Difficulties Relationship Problems Relationship-Communication Relationship/Marriage Issues Relieving Factors School/Work Problems/Challenges Self Esteem Serious Medical Problems Service Coordination & Provider Collaboration Sexual Abuse Victim Sexual bx Sexual Difficulties/Dysfunction/Problems Sexuality/Sexual Issues Sleep Disturbance Sleep/Sleep Disturbance/Sleep Problems [/textarea] [textarea] Social Social Conflict/Stressors Social Discomfort Social Isolation Social/Family History Changes; Social/Friends/Dating Something Specific, Such As Particular Event Somewhat Satisfied Sore Throat Spiritual Factors Strep T/P Stressors Are Evoking Symptoms Of Depression Stye [/textarea] [textarea] Substance Abuse Substance Use Suicidal Ideation Suicidal Ideation W/ Method, Plan & Intent Thinking Would Be Better Off Dead / Hurting Self In Some Way* If Checked Box Should Talk About Feelings W/ Healthcare Provider As Soon As Possible There Is Help Available Thoughts Of Death Throat Pain Timing [/textarea] [textarea] Tonsillitis Trauma Trouble Concentrating On Things, Such As Reading Newspaper / Watching Television Trouble Falling / Staying Asleep, / Sleeping Too Much Trust Issues Type A Bx Underemployed Underweight Unknown At Time Of Intake Unrealistic Expectations Upper Respiratory Tract Infection Urti [/textarea] [textarea] Using etoh / Drugs, / Being High From etoh / Drugs, / Hungover From etoh / Drugs While Feeling Like Working, Going To School, Ortaking Care Of Children / Other Responsibilities Viral Rash Vocational Stress Vomiting Wheezing Work Problems/Challenges [/textarea]
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