4 ways that make parkinson's disease and parkinsonism different and how to code for them in icd-10

by Simone Grimes III 3 min read

What is parkinsonism and what are the symptoms?

Parkinsonism is a general term that refers to a group of neurological disorders that cause movement problems similar to those seen in Parkinson’s disease such as tremors, slow movement and stiffness. Under the category of parkinsonism there are a number of disorders, some of which have yet to be clearly defined or named.

Is there a syndrome that mimics parkinsonism?

Under the category of parkinsonism there are a number of disorders, some of which have yet to be clearly defined or named. Early in the disease process, it is often hard to know whether a person has idiopathic (meaning “of unknown origins”) Parkinson’s disease or a syndrome that mimics it.

What are the signs and symptoms of advanced Parkinsons Disease?

Advanced Parkinsons disease, stage 4 or 5 of the Hoehn and Yahr Scale, is characterized by very limited mobility without assistance, severe motor deficits, risk of falls, and cognitive and psychotic problems.

What is the difference between parkinsonism and Parkinson's disease?

Parkinson's is caused mainly by the degeneration of nerve cells in the brain, while the causes of parkinsonism are numerous, ranging from the side effects of medications to chronic head traumas to metabolic diseases to toxins to neurological diseases.

Is parkinsonism and Parkinson's disease coded to the same code?

Parkinsonism refers to symptoms of Parkinson's disease (e.g., dementia, slow movements and tremors), regardless of the cause, and is typically caused by another condition or external agent, such as drugs. These two conditions are not classified the same.

What are the 4 classic features of Parkinson's disease?

From the motor standpoint PD is characterized by a clinical syndrome universally known as parkinsonism, which includes four cardinal features: bradykinesia, rest tremor, rigidity, and postural and gait impairment.

How do you code parkinsonism?

ICD-10-CM Coding: You will see Parkinsonism dementia listed and an additional code F02. 80 which appears in brackets and indicates this code would be assigned also but as a secondary. In the tabular code G20 represents PD, and it would be sequenced first, followed by the manifestation(s). Code F02.

What is the ICD-10 diagnosis code for Parkinson's disease?

G20 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM G20 became effective on October 1, 2021. This is the American ICD-10-CM version of G20 - other international versions of ICD-10 G20 may differ.

What is ICD in Parkinson's disease?

Impulse Control Disorders (ICDs) are a group of excessive and/ or harmful urges and behaviors that may occur in patients with Parkinson's disease (PD). They are characterized by persistent thoughts or uncontrollable urges to do things. They often are a side effect of certain medications.

What are the 3 classic features of Parkinson's disease?

The 3 cardinal signs of Parkinson disease are resting tremor, rigidity, and bradykinesia.

What are the five 5 signs of Parkinson disease?

Parkinson's signs and symptoms may include:Tremor. A tremor, or shaking, usually begins in a limb, often your hand or fingers. ... Slowed movement (bradykinesia). ... Rigid muscles. ... Impaired posture and balance. ... Loss of automatic movements. ... Speech changes. ... Writing changes.

What are the three cardinal features of Parkinson's disease?

The three "cardinal" motor symptoms of PD are: Stiffness (rigidity): muscle stiffness detected by a doctor on examination. Slowness (bradykinesia): decrease in spontaneous and voluntary movement; may include slower walking, less arm swinging while walking, or decreased blinking or facial expression.

What is the ICD 9 code for Parkinson's disease?

The ICD-9 CM code, 332.0, which is generally considered the code to identify Parkinson's disease, did not distinguish between parkinsonism and Parkinson's disease.

What is the cause of Parkinsonism?

Parkinson's disease is caused by a loss of nerve cells in the part of the brain called the substantia nigra. Nerve cells in this part of the brain are responsible for producing a chemical called dopamine.

Can you code Parkinson's and Lewy body dementia?

In the ICD-10-CM Alphabetic Index, dementia with Parkinsonism refers to Lewy body dementia (G31. 83 Dementia with Lewy bodies). In these cases, the symptoms are similar to Parkinson's disease, but that is not the patient's diagnosis. To code diagnosed Parkinson's disease with dementia, use G20 Parkinson's disease.

How to get rid of Parkinson's disease?

Hobbies and Socializing . If you have hobbies then try to continue with them, or find new pastimes that will help take your mind off Parkinson’s disease and give you something else to focus on. Try to keep up with friends and family on a social level so that you don’t become isolated.

How to help Parkinson's patients?

3. Hobbies and Socializing.

What are some ways to help with Parkinson's disease?

There are many complementary therapies that may help with the symptoms of Parkinson’s disease. Meditation, acupuncture, use of essential oils and reflexology are among the many therapies you may find useful. 5.

Is it hard to live with Parkinson's?

We know that living with Parkinson’s disease can be difficult and the condition poses many challenges, however, there are ways to manage it that can help make everyday life more comfortable. With this in mind, we’ve put together a list of seven ways to self-manage Parkinson’s disease based on information from Parkinson’s UK.

What are the symptoms of Parkinson's disease?

The early stages of PD include the following signs and symptoms: Slight shaking of a finger, hand, leg, chin, or lip. Stiffness or difficulty walking. Difficulty getting out of a chair.

How many people are affected by Parkinson's disease?

As a neurodegenerative disease of the brain, which impacts an individual’s motor function, Parkinson’s Disease (PD) is the most common neurological disorder, affecting approximately one million people in the United Status. It is estimated that approximately 60,000 Americans are diagnosed with PD each year, and this number does not reflect ...

What is the PD G20 code?

With PD G20 code, you will be coding associated signs and symptoms or those complications not necessarily inherent to the disease. Most of these complications will be found in Chapter 18, as signs and/or symptoms.

What are the most common drugs for PD?

The first category includes drugs that increase the level of dopamine in the brain. The most common drugs for PD are dopamine pre cursors—substances such as levodopa that cross the blood-brain barrier and are then changed into dopamine.

What is the third category of medication for PD?

The third category of drugs prescribed for PD includes medications that help control the non-motor symptoms of the disease ; that is, the symptoms that don't affect movement. For example, people with PD-related depression may be prescribed antidepressants.

What is the second category of PD drugs?

The second category of PD drugs affects other neurotransmitters in the body in order to ease some of the symptoms of the disease. For example, anticholinergic drugs interfere with production or uptake of the neurotransmitter acetylcholine. These can be effective in reducing tremors.

How many people have PD?

Worldwide up to 14 million people have a diagnosis of PD. Most individuals with PD are diagnosed when they are 60 years old or older, but early-onset PD also occurs, like that of actor Michael J. Fox and deceased professional boxer Muhammad Ali.

PD Progression & Motor Complications

PD is a chronic, progressive disorder affecting approximately 1 million people in the US. 3-5 Disease progression causes greater morbidities and disabilities because of advancing fluctuations in motor and nonmotor symptoms.

Limitations of Current ICD-10-CM Coding for PD

Unlike other neurologic disorders (eg, migraine and epilepsy), there is only a single ICD-10-CM code for PD, namely G20. 22 The single, nonspecific code for PD cannot accurately capture motor fluctuations and dyskinesia that emerge with PD progression.

Recommendations for PD ICD-10-CM Coding

Based on this review, the panel recommends the ICD-10-CM coding structure for PD be expanded to provide specificity to distinguish motor complications of dyskinesia and/or “OFF” episodes (Table 2; Figure 1).

Revising PD ICD-10-CM Coding May Improve Care

The current, single, nonspecific ICD-10-CM code for PD does not accurately specify patients with motor complications, including “OFF” episodes and dyskinesia.

Support for Revision of ICD-10-CM Codes for PD

The American Academy of Neurology supports the need to update the ICD-10-CM coding to better reflect the progression of PD. Patient advocacy groups also support this need, including the Michael J.

Summary

Revision of the ICD-10-CM coding structure for PD is a major unmet need for a population that is expected to continue to increase over the next decade. The treatment paradigm for PD continues to evolve with specific medications now available for PD dyskinesia and for the on-demand management of “OFF” episodes in PD.

What is the ICD code for vascular parkinsonism?

G21.4 is a billable ICD code used to specify a diagnosis of vascular parkinsonism. A 'billable code' is detailed enough to be used to specify a medical diagnosis.

What is the most common cause of parkinsonism?

The neurodegenerative condition Parkinson's disease (PD) is the most common cause of parkinsonism. However, a wide range of other etiologies may lead to a similar set of symptoms, including some toxins, a few metabolic diseases, and a handful of neurological conditions other than Parkinson's. Specialty:

What is the approximate match between ICd9 and ICd10?

This is the official approximate match mapping between ICD9 and ICD10, as provided by the General Equivalency mapping crosswalk. This means that while there is no exact mapping between this ICD10 code G21.4 and a single ICD9 code, 332.0 is an approximate match for comparison and conversion purposes.

Is Parkinson's disease a neurodegenerative disease?

Parkinsonism shares symptoms found in Parkinson's disease, from which it is named; but parkin sonism is a symptom complex, and differs from Parkinson disease which is a progressive neurodegenerative illness. The underlying causes of parkinsonism are numerous, and diagnosis can be complex. The neurodegenerative condition Parkinson's disease (PD) is the most common cause of parkinsonism. However, a wide range of other etiologies may lead to a similar set of symptoms, including some toxins, a few metabolic diseases, and a handful of neurological conditions other than Parkinson's.

What Is Parkinson’s Disease?

  • Parkinson’s disease is a neurodegenerative brain disorder that progresses slowly in most people. Symptoms can take years to develop, and most people live for many years with the disease. The symptoms caused by Parkinson’s include an ongoing loss of motor control (resting tremors, stiffness, slow movement, postural instability) as well as a wide range of non-motor symptoms (…
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What Is Parkinsonism?

  • Parkinsonism is a general term that refers to a group of neurological disorders that cause movement problems similar to those seen in Parkinson’s disease such as tremors, slow movement and stiffness. Under the category of parkinsonism there are a number of disorders, some of which have yet to be clearly defined or named. Early in the disease process, it is often h…
See more on parkinson.org

Diagnosis

  • There is no definitive test to detect Parkinson’s disease or parkinsonism. For diagnosis, doctors take a thorough medical history and may request a number of movement tests. Because of the observational nature of the diagnosis, Parkinson’s can sometimes be confused with parkinsonism, and the diagnosis may need to be revised over time based on speed of disease pr…
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Treatment

  • There is overlap in treatment for Parkinson’s and parkinsonisms. Dopaminergic therapy (the first line treatment for Parkinson’s) can be effective in some parkinsonisms. A regular daily exercise program is vital for maintaining muscle tone, strength and flexibility. Other common treatments for both Parkinson’s and parkinsonisms include physical, occ...
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Resources

  • Lewy Body Dementia Association (800) 539-9767 www.lbda.org The Multiple System Atrophy Coalition (866) 737-5999 www.multiplesystematrophy.org Cure PSP: Foundation for PSP, CBD and Related Brain Diseases (800) 457-4777 [email protected] www.psp.org
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