Skip to main content

Dementia

 Dementia

ICD-10-CM classifies dementia on the basis of: etiology, severity and associated behavioral disturbances. 

Etiology refers to the type of dementia. This can include:

    Vascular dementia F01

    Dementia in other diseases classified elsewhere F02

    Unspecified dementia F03

Severity includes mild, moderate and severe:

                Mild - Clearly evident functional impact on daily life, affecting mainly instrumental activities. No longer fully independent; requires occasional assistance with ADLs.

                Moderate - Extensive functional impact on daily life with impairment in basic activities. No longer independent; requires frequent assistance with ADLs.

                Severe - Clinical interview may not be possible. Complete dependency due to severe functional impact on daily life with impairment in basic activities, including basic self-care.

                *interpretation of results from MoCA score


The diagnoses include options for associated behavioral disturbances: (5th-6th digits in code)

                0 = without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety

                11 = with agitation

                18 = with other behavioral disturbance

                2 = with psychotic disturbance

                3 = with mood disturbance

                4 = with anxiety

 

Also include documentation of:

Complications to dementia: Wandering Z91.83, Sundowning F05, restlessness, violence, delirium, etc.

 

Documentation tips:

Dementia should be linked to any known etiology with causal language, e.g. “Dementia due to Parkinson’s disease.” This documentation results in two codes: Parkinson’s G20, Dementia in diseases classified elsewhere F02.80.

 



Disclaimer: This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and complete coding. This blog may contain references or links to statutes, regulations, or other policy materials. It is not intended to take the place of either the written law or regulations.  The information presented herein is for general informational purposes only and is accurate as of the date of publication.

Comments

Popular posts from this blog

MEDICARE PREVENTIVE SERVICES FROM MEDICARE LEARNING NETWORK

This is a link to further information on the Medicare Preventive Services. The layout of it reminds me of a bingo card!  Medicare Learning Network is the educational arm of Centers for Medicare and Medicaid Service (CMS). Remember this is further information on different types of screenings available to Medicare beneficiaries. https://www.cms.gov/Medicare/ Prevention/PrevntionGenInfo/ medicare-preventive-services/ MPS-QuickReferenceChart-1. html#AWV Disclaimer: This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and complete coding. This blog may contain references or links to statutes, regulations, or other policy materials. It is not intended to take the place of either the written law or regulations.  The information presented herein is for general informational purposes only and is accurate as of the date of publication.

Table VI-4. Disease Hierarchies for the 2017 CMS-HCC Model

If the Disease Group is Listed in this column… …Then drop the Disease Group(s) listed in this column is found here : Announcement of Calendar Year (CY) 2017 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter Found at: https://www.cms.gov/Medicare/HealthPlans/MedicareAdvtgSpecRateStats/Downloads/Announcement2017.pdf P 87 If the Disease Group is Listed in this column… …Then drop the Disease Group(s) listed in this column Disclaimer: This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and complete coding. This blog may contain references or links to statutes, regulations, or other policy materials. It is not intended to take the place of either the written law or regulations.  The information presented herein is for general informational purposes only and is accurate as of the dat...

Signature requirements

The Medicare Program Integrity Manual contains the guidance around signature requirements.  They are  found in chapter 3. 3.3.2.4 - Signature Requirements  This material was also covered in the Part AB November 2025 webinar by Noridian entitled: Signature Requirements Disclaimer: This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and complete coding. This blog may contain references or links to statutes, regulations, or other policy materials. It is not intended to take the place of either the written law or regulations.  The information presented herein is for general informational purposes only and is accurate as of the date of publication.