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Reader Question:

Don't Upcode With Alzheimer's

Published on Wed Mar 14, 2007

Question: We are monitoring IV antibiotics used to treat an Alzheimer's patient's pneumonia following his return from the hospital. Our nurse realized that the patient is having swallowing difficulties, so she had speech therapy come in to work with the patient and family to try to prevent further aspiration. Which should we code as primary -- pneumonia or Alzheimer's?

California Subscriber


Answer: The answer depends on your primary focus of care, but your choices are between dysphagia or pneumonia.

Coding Alzheimer's as primary would indicate that you are providing multiple aspects of care related to the Alzheimer's. But your speech therapist is working on only one aspect of the Alzheimer's --the swallowing difficulties.

If the dysphagia is the primary focus of care, code as follows:

  • M0230a: 787.2 (Dysphagia);
  • M0240b: 486 (Pneumonia, organism unspecified) or 507.0 (Pneumonitis due to inhalation of food or vomitus); and
  • M0240c: V58.81 (Fitting and adjustment of vascular catheter).

If you know which organism is causing the pneumonia, that may change the pneumonia code from 486.

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