Posts tagged ‘dementia’

August 4, 2011

New codes seminar!

My new codes seminar is rapidly approaching … come listen Aug. 19, 1-2:30pm CDT for a few highlights of the nearly 200 new and changed diagnosis codes for 2012 including:
• Expanded codes for E coli from one to 4 new codes.
• 40 new skin cancer codes that will add both case mix and non-routine supply points.
• New probably case mix codes for dementia without a specific underlying etiology will allow recognition of the presence or absence of behavioral issues and a change to what is described as a behavioral issue.
• Changes to the V code for history of pulmonary embolism.
• New complication codes associated with gastric band surgery, cystostomies and stem cell transplants.
• Specific V codes for acquired absence of joints when a prosthetic joint has been removed and replaced with a spacer.


July 14, 2011

Will 294.20 and 294.21 take over as main dementia codes?

Two of the code set that go live Oct. 1 are new dementia codes 294.20, Dementia, unspecified, without behavioral disturbance
(Dementia NOS), and 294.21, Dementia, unspecified, with behavioral disturbance (This code includes dementia with Aggressive behavior, Combative behavior, or Violent behavior.

We have been coding with 294.10 and 294.11, which indicate Dementia in conditions classified elsewhere either with (.10) or without (.11) behavioral disturbance.

There are no Code First, or Code Underlying commands for the new 294.2x codes, so they hold an advantage that they shouldn’t be manifestation codes like the 294.1x codes. This means the 294.2x should be valid when you don’t know the disease causing the dementia, but  you have the dementia diagnosis.

It’s hard to say how much these new codes will “take over” the 294.1x codes, but hopefully, they will reduce the coding of the more vague 294.8 (Other persistent mental disorders due to conditions classified elsewhere).

Note: If your patient wandered off because of the dementia, 294.11 may have been your code, but Wandering off has been stripped from that code. See if Wandering in conditions classified elsewhere (V40.31) might describe your patient’s condition.

June 30, 2011

New codes quiz time

It’s that time of year … the final new code lists are out, and we need to start learning. Here are some fill-in-the-blank to help you learn new codes: (Answers at the bottom)

1. Look up this main term to see changes to 416.8

2. You should use one or two additional codes (if you have documentation) with this new Infection of cystostomy code

3. Category 539 deals with complications of these procedures

4. Acquired absence of a joint now has this subcategory

5. Several codes, including chronic pulmonary embolism (416.2) and pulmonary embolism and infarction (415.1) now have excludes notes for these types of codes

6. Other infections with the central _____ catheter has new codes

7. This code now deals with aggressive behavior in dementia

8. Influenza codes in categories 487 and ___ have gotten more specific

9. *Local* infection due to central venous catheter is coded here

10. This chapter received a new title this year

11. There are more than 10 new codes and 20 revisions for this eye disease

12. NCHS’s correction addendum swapped out V54.81 with V54.82 when coding this V58 subcategory

13. V40.31, Wandering in diseases classified elsewhere, excludes Alzheimer’s and this symptom often association with Alzheimer’s

14. Complications codes are getting more complicated. Don’t code 596.8x with this urinary complications code

15. When coding some atherosclerosis codes, watch the use additional code note on some codes in this category

16. Pelvic fractures (808.5x) now have specificity for open or ______

17. This phrase is now used to describe the previously known “mental retardation”

18. For skin cancer codes, a fifth-digit of 2 designates squamous cell _____

More to come on new codes, but if you’re looking for the complete Index and Tabular listings, as well as the errata, go to this NCHS list.


1. hypertension; 2. 596.81; 3. bariatric; 4. V88.2; 5. personal history; 6. venous; 7. 294.21; 8. 488; 9. 999.93; 10. five; 11. glaucoma; 12. V58.9; 13. dementia; 14. 997.5; 15. 707; 16. closed; 17. intellectual disabilities; 18. carcinoma

November 11, 2010

November is National Alzheimer’s Awareness Month

According to the Alzheimer’s Association, there are more than 5 million Americans living with Alzheimer’s disease.
Alzheimer’s coding needs to be thought of in terms of multiple aspects of care or multiple symptoms/conditions caused by the Alzheimer’s.
In order to code Alzheimer’s (331.0) primary, multiple issues must be related to this diagnosis. Let’s say your patient had dementia and dysphagia, both specifically documented as related to the Alzheimer’s. You would code 331.0, 294.11, 787.20 with Alzheimer’s primary because of the multiple manifestations of the disease.
If the patient was only being treated for dysphagia related to Alzheimer’s, you would code 787.20, 331.0. That one point of care should be the primary code, not the underlying long-term condition.

Go here for more information on Alzheimer’s facts and figures.