Wiki Dementia coding

[Ireneco08@yahoo.com]

Our providers very often document causal relationships between dementia and conditions such as:
Depression
Anxiety
Psychosis
Delusions
Hallucinations
Therefore I am seeking clarity how to properly code:
Dementia with Depression
Is it F03.90 and F32.9 or just F03.90?

Dementia with Anxiety
Is it F03.90 and F41.9 or just F03.90?

Dementia with Psychosis
Is it F03.90 and F29 or just F03.90

Any clarification on this would be most helpful.
Thank you.

 

[pscanlan]

Generally I would try to be as specific as possible, particularly if the provider is trying to demonstrate a causal link. I would list both codes if, for example, the depression symptoms are severe enough to warrant documentation or medication. I don't think there is any downside to adding a depression, anxiety, or psychosis code alongside the dementia code, as the patient has both conditions. Nothing in the description of F03.90 says "with psychosis" or "with depression" it simply mentions lack of behavioral symptoms. Now that I read the code listing again, depressive episodes are behavioral symptoms; so are anxiety and psychosis. I would probably use F03.91 + F32.9. F03.90 would be for cases of forgetfulness, or other less severe concomitants.

I don't know. If you read here the description of approximate symptoms for F03.90 includes dementia with depression, etc. That's very confusing. I would have thought that depression, anxiety and psychosis are behavioral disturbances as a matter of course. Maybe someone who works more closely with psych specialties can offer a more definitive opinion, I've only ever worked on the periphery of that specialty. To reiterate though, I'd bill both codes.