Parkinson's Disease, Parkinsonism, and ICD-10 Codes

by  Find-A-Code™
Sep 19th, 2023

Regular readers of our blog know that we advocate for online lookup of ICD-10 codes due to the complex nature of medical coding itself. In short, medical coding is complicated. There are lots of different paths a coder can take when coding a particular visit or procedure. Take Parkinson's disease and parkinsonism. They are completely different from the coder's standpoint.

It would be far too easy for a new medical coder to be confused about parkinsonism when looking up ICD-10 codes for Parkinson's disease. That is because different codes are used depending on symptoms and how far a patient's disease has progressed. But many of the symptoms associated with the disease are also associated with parkinsonism. Therein lies the rub.

Parkinson's Disease Is Specific

Parkinson's disease is a specific disease that falls under the broader banner of parkinsonism. It is believed to be caused by a gradual loss of nerve cells in the brain. What causes the loss is unclear. However, cell loss is specific to Parkinson's disease. There are other types of parkinsonism which manifest similar symptoms but have a quite different cause.

Looking up ICD-10 codes requires not only understanding the differences between Parkinson's disease and parkinsonism, but also the root cause of the patient's problem. This is where clear communication between clinician and medical coder becomes critical.

Symptoms of Parkinson's Disease

As a side note, Parkinson's disease manifests itself with a variety of symptoms. Not every patient experiences all of them. Furthermore, some symptoms are only observed after the disease has progressed to a certain level. Here are some of the most common symptoms associated with Parkinson's:

• Dementia
• Hallucinations
• Depression
• Sleeping problems
• Difficulty speaking
• Difficulty chewing and swallowing
• Urinary and bowel dysfunction

Parkinson's disease may be coded differently as the disease progresses. Medical coders need to start with the disease itself and follow a path, based on symptoms and disease stages, to arrive at the correct codes. It is easier said than done.

Parkinsonism Is More Broad

Complicating things for medical coders is the fact that parkinsonism isn't just a single condition or disease. The term itself is a broad term referring to a group of neurological disorders with movement-related symptoms similar to those of Parkinson's disease. Examples of such symptoms include stiffness, tremors, and the inability to move quickly.

Although Parkinson's disease is the most prevalent form of parkinsonism, it is not so dominant that the other forms are virtually unheard of. Upwards of 15% of all parkinsonism cases involve a form that is not Parkinson's disease. Common examples include:

• Drug-Induced Parkinsonism – This form is attributable to certain types of prescription medications that create the symptoms. Antipsychotic medications come to mind.
• Vascular Parkinsonism – Blood vessel damage can lead to a loss of dopamine in the brain, thereby resulting in parkinsonism's movement-related symptoms.

Several other disorders, all of which are considered rare, can also create the movement-related symptoms. Progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) are just two examples.

For medical coders, trying to correctly code the other forms of parkinsonism can be difficult. They don't start with Parkinson's disease and work that path down through symptoms. Rather, they start with parkinsonism to work an entirely different path to arrive at the correct codes.

Suffice it to say that the explanation provided in this post has been a very basic one. There is so much more to Parkinson's disease and parkinsonism that we did not include here. But the little information offered does at least illustrate why we advocate looking up ICD-10 codes online. Online lookup is faster, more efficient, and arguably more accurate.