Neurology & Pain Management Coding Alert

Question:Does ICD-9 include a code for impaired decision making?South Carolina SubscriberAnswer: ICD-9 does not have a diagnosis specifically for impaired decision making, which means you need to learn more about the situation before coding. Your best option is to query the physician about various ICD-9 code options such as 331.83 (Mild cognitive impairment, so stated), a choice from 799.5x (Signs and symptoms involving cognition), or 294.9 (Unspecified persistent mental disorders due to conditions classified elsewhere). Other possibilities could range from late effect of a closed head injury (907.0) or Alzheimer's (331.0) to dementia with Lewy bodies (331.82), schizophrenia (295.xx), multiple sclerosis (340), or more. Diagnosis 294.9 might be the choice if you have no further information, but it is always better to ask for additional information rather than default to an unspecified code that potentially would not be accurate.