AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2017 Quarter 2; Ask the Editor
Parkinson’s Dementia versus Parkinsonism
A patient diagnosed with dementia due to Parkinson’s disease and aggressive behavior is admitted for treatment. The ICD-10-CM Alphabetic Index to Diseases and Injuries for Parkinson’s dementia with behavioral disturbance seems inconsistent. Depending on which Index entry is used, either code G20 , Parkinson’s disease or code G31.83 , Dementia with Lewy bodies, is assigned. The Alphabetic Index entry for “Dementia” has subentries for Parkinsonism ( G31.81 ) and Parkinson’s disease ( G20 ). However, the Index entry for Parkinson’s disease directs to see Parkinsonism. This instructional note is mandatory and indicates Parkinson’s disease is coded as Parkinsonism. What is the appropriate code assignment for Parkinson’s dementia with aggressive behavior? ...
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Article Overview
This article discusses an ICD-10-CM Alphabetic Index issue involving dementia associated with Parkinson’s disease, related Parkinsonism terminology, and conflicting index pathways that can affect code assignment. It is aimed at coders, CDI staff, and other healthcare billing professionals who need to understand how the index structure and cross-references impact documentation review and diagnosis coding. The article focuses on the indexing guidance, related dementia terminology, and the implications of the mandatory see reference within the ICD-10-CM Index.
Why This Topic Matters
When documentation uses Parkinson’s-related dementia language, the index structure can lead coders to different diagnosis options if the terminology is not interpreted consistently. Understanding the indexing relationships helps reduce coding inconsistency for records involving dementia, Parkinsonism, and Parkinson’s disease.
What You Will Learn
- How Parkinson’s-related dementia terminology is represented in the ICD-10-CM Alphabetic Index
- Why cross-references in the index can affect diagnosis code selection
- What broad indexing issue is being highlighted for Parkinson’s disease and Parkinsonism terminology
- How behavioral disturbance language fits into the coding discussion at a general level
Who Should Read This
- Medical coders
- Coding auditors
- Clinical documentation integrity specialists
- Revenue cycle staff
- Healthcare billing professionals
Codes Discussed
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