Wiki HCC coding for dementia (2017 outpatient dx guidelines)

[eacwc]

I have a question about how dementia should be coded in this scenario. (This is for HCC coding.) Here is how the dx reads:
1. Dementia, suspect either Alzheimer's or microvascular changes.
2. Early Parkinson's, but still able to adequately perform ADLs.

The answer I was given was G31.83, F02.80, and the reasoning was because this is coded using outpatient guidelines, you can't code suspected diagnoses. And because of the definition of the word "with" in the alphabetic index, it is correct to code Parkinson's with dementia even though it's not explicitly stated in the dx. My problem is that it seems that the provider IS specifying what he thinks is causing the dementia, and Parkinson's isn't it. Two possible causes are mentioned, and Parkinson's is mentioned separately. I know it's hard to code hypotheticals, but any insight would be appreciated!

 

[Aparna2014]

G20 is correct code if we want to give combination for dementia and early parkinsons

I agree it is a hypothetical question.

If we go for dementia with parkinsons the code leads to G20.

The type 1 excludes for G20 is G31.83

So i think the correct code would be G20 if we want to give a combination code.

It is according to client specific guidelines whether we have to take combination code or not bcz some companies say it should be documented with particularly to code a combination code. Please check with your manager before coding.


If we want to give combination code as Dementia with parkinsons the code is G20.

When leading to the index it is having both parkinsonism and parkinsons disease.


Because the scenario says Early parkinsons it is acceptable to code G20 not G31.83.

Parkinson’s disease (PD) is the most common neurodegenerative cause of parkinsonism, a clinical syndrome characterized by lesions in the basal ganglia, predominantly in the substantia nigra. PD makes up approximately 80% of cases of parkinsonism.