Per the ICD-10-CM Alphabetic Index, G30.9 would be reported first, followed by F02.81 or F02.80 to show dementia with or without behavioral disturbances . Since the codes F02.80 and F02.81 are in brackets, these are considered a manifestation of the disease and would be sequenced second per the Official Guidelines for Coding and Reporting (1.A.13) or pages 11 & 12 of FY2017.
What is Alzheimer’s disease? Alzheimer’s is a progressive neurodegenerative disease that destroys memory, mental function, thinking skills and affects the behavior of those plagued with the disease. In the disease process, the brain cells degenerate and die which leads to dementia/decline in memory and mental function.
The coma scale codes (R40.2-) can be used in conjunction with traumatic brain injury codes, acute cerebrovascular disease or sequelae of cerebrovascular disease codes. These codes are primarily for use by trauma registries, but they may be used in any setting where this information is collected.
A medical coding audit is a process that includes internal or external reviews of medical coding and billing accuracy, procedures or policies in place, and any other component that affects the medical record documentation. Medical coding audits….
In January, new CPT codes were released. There were 248 new CPT codes added, 71 deleted and 75 revised. Most of the surgery section changes were in the musculoskeletal and cardiovascular subsections. These included procedures such as skin grafting, breast biopsies, deep drug delivery systems, tricuspid valve repairs, aortic grafts and repair of iliac artery.
A coronary artery endarterectomy is not always performed during a CABG procedure, so when it is performed it becomes confusing as to whether to code it separately or not.
Anticoagulants and antiplatelets are used for the prevention and treatment of blood clots that occur in blood vessels. Oftentimes, anticoagulants and antiplatelets are referred to as “blood thinners,” but they don’t actually thin the blood at all. These drugs slow down the body’s process of making clots.
Vascular dementia: This is the second most common type of dementia. Vascular dementia can occur if a stroke blocks an artery in the brain. Other causes include conditions that damage blood vessels, affect circulation, and deprive the brain of vital oxygen and nutrients.
To diagnose the cause of the dementia, the physician must identify the pattern of the loss of skills and function and determine what functions the person can still perform. As a January 2019 AAPC article states, to assign the ICD-10 code, the documentation should correctly specify the root cause of the dementia.
According to www.alz.org, at least two of the following core mental abilities must be significantly affected to be considered dementia: 1 Memory 2 Communication and language 3 Ability to focus and pay attention 4 Reasoning and judgment 5 Visual perception
Progressive dementia types are not reversible and include: Alzheimer’s disease: Alzheimer ’s disease is the most common cause of dementia , ...
Alzheimer’s disease: Alzheimer’s disease is the most common cause of dementia, accounting for 60% to 80% of cases. It is caused by genetic, lifestyle and environmental factors that affect the brain cells and causes memory loss and cognitive decline over time. There are four ICD-10 codes to report the condition:
Frontotemporal dementia: This is a group of dementias caused by progressive nerve cell damage in the brain’s frontal lobes or its temporal lobes. This causes deterioration in behavior, personality and/or difficulty with producing or comprehending language.
Good medical record documentation is essential to describe the severity of illness, to improve and measure quality of care, to provide better data for research, and for optimal reimbursement.
There are two more codes that deserve attention. The first code is for delirium due to a known physiological condition, F05 De lirium due to known physiological condition. Although individuals with dementia may have delusions or hallucinations, delirium is frequently due to infection (often, a urinary tract infection), medication mismanagement, etc. It should not be considered a symptom of dementia unless the provider documents it as such.#N#The second code is for wandering, Z91.83 Wandering in diseases classified elsewhere. Wandering is one of the most dangerous symptoms for patients with dementia. The Alzheimer’s Association reports that six in 10 people (60 percent) with dementia will wander at some point. Be sure to code this behavior if documented in the medical record. Wandering is a warning to caregivers and medical providers that the individual is at high risk for injury and situations that may result in death. Measures that may need to be taken, including additional caregiving staff, relocation to a monitored living setting, etc., depend on documentation in the medical record and proper coding.
ICD-10-CM provides codes for memory loss without a dementia, as well. First, know that a certain amount of memory loss is a normal part of aging and is not a disease process. This is determined by whether the memory loss is about equal to people of the same age, or if it is significantly more.#N#For those who share about the same amount of forgetfulness as everyone else their age, use R41.81 Age-related cognitive decline. For patients experiencing more decline than is expected for their age, and if the provider specifically documents “mild cognitive dementia,” use G31.84 Mild cognitive impairment, so stated. This diagnosis carries a lot of emotional weight and potential impact to a patient’s life decisions. If you have doubt about the correct code, query the provider.
Alzheimer’s Disease. Many people who suffer from Alzheimer’s disease may experience phases of agitation, aggression, combativeness, etc. These symptoms dramatically influence the level of care needed to keep the individual safe, so it’s very important to code this information if it is included in the documentation.
To code diagnosed Parkinson’s disease with dementia, use G20 Parkinson’s disease. Also use a secondary code for “without behavioral disturbance” (F02.80) or “with behavioral disturbance” (F02.81). Query the provider if the documentation is not clear enough for you to make a determination.
Coding to this level of detail not only helps to tell a more complete medical story that can improve the patient’s health outcome, but also assists researchers and policymakers in determining how prevalent the diseases are and their related symptoms.
This is the second most frequent cause of dementia behind Alzheimer’s disease . ICD-10-CM combines the disease with the behavior.
To code vascular dementia without behavioral disturbance, use only the combination code F01.50 Vascular dementia without behavioral disturbance. For vascular dementia with behavioral disturbance, use only the combination code F01.51 Vascular dementia with behavioral disturbance.