AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2023 Quarter 4; New/Revised ICD-10-CM Codes
Parkinson’s Disease with OFF Episodes
A 67-year-old male patient was referred to a movement disorders outpatient clinic due to a one-year nondisabling intermittent resting tremor of the left hand, that later progressed to also involve the contralateral hand. On neurological examination, the patient had normal cognition. Myerson sign (glabellar tap reflex) was present. Oculomotor examination was normal. An intermittent mild resting tremor was observed in the left hand, as well as mild signs of asymmetrical cogwheel rigidity and bradykinesia (left >right). Gait and balance were normal as well as postural reflexes. The patient was diagnosed with idiopathic Parkinson’s disease. How is this presentation of Parkinson’s disease coded? ...
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Article Overview
This article covers an update to ICD-10-CM Parkinson’s disease coding, including newly created subcategories that distinguish Parkinson’s disease with and without dyskinesia and with and without fluctuations, along with an unspecified Parkinsonism category. It also discusses the clinical concepts behind these terms and presents a coding-oriented patient scenario for context. The article is relevant to coders, auditors, clinicians, and revenue cycle staff who work with neurology documentation and diagnosis coding.
Why This Topic Matters
Parkinson’s disease documentation can vary by symptom pattern and treatment-related fluctuation status, so this update affects diagnosis specificity and code selection in neurology-related claims and records.
What You Will Learn
- How the ICD-10-CM Parkinson’s disease category was expanded
- The general clinical meaning of dyskinesia and fluctuations in Parkinson’s disease
- How Parkinsonism is distinguished at a high level from Parkinson’s disease in the update
- How a coding vignette is used to illustrate the topic
Who Should Read This
- Medical coders
- Coding auditors
- Clinical documentation specialists
- Revenue cycle staff
- Neurology practices
Codes Discussed
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