ICD-10 Coding for Dementia with Psychosis(F02.81, G30.9)
Complete ICD-10-CM coding and documentation guide for Dementia with Psychosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Dementia with Psychosis
F01-F03Primary Range
Mental and behavioral disorders due to known physiological conditions
This range includes codes for different types of dementia, including those with behavioral disturbances such as psychosis.
Diseases of the nervous system, specifically Alzheimer's disease and other degenerative diseases
These codes are used to specify the etiology of dementia, such as Alzheimer's disease.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| F02.81 | Dementia in other diseases classified elsewhere with behavioral disturbance | Use when dementia is secondary to another condition and includes psychotic symptoms. |
|
| G30.9 | Alzheimer's disease, unspecified | Use to specify the etiology of dementia when Alzheimer's disease is diagnosed. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for dementia with psychosis
Essential facts and insights about Dementia with Psychosis
Primary ICD-10-CM Codes for dementia with psychosis
Decision Criteria
clinical Criteria
- Presence of delusions or hallucinations documented in the patient's medical record.
documentation Criteria
- Clear documentation of psychotic symptoms occurring after dementia onset.
Applicable To
- Dementia with psychotic symptoms
Excludes
- Dementia without behavioral disturbance
Clinical Validation Requirements
- Documented evidence of psychotic symptoms such as delusions or hallucinations occurring after the onset of dementia.
Code-Specific Risks
- Misclassification if psychosis is not clearly documented as secondary to dementia.
Coding Notes
- Ensure the documentation specifies the type of psychotic symptoms and their onset relative to dementia.
G30.9 - Alzheimer's disease, unspecified
Use to specify the etiology of dementia when Alzheimer's disease is diagnosed.
Applicable To
- Alzheimer's disease NOS
Excludes
- Vascular dementia
Clinical Validation Requirements
- Diagnosis confirmed by clinical assessment and/or biomarkers.
Coding Notes
Always sequence this code before dementia codes when Alzheimer's is the underlying cause.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Sundowning
R41.81Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Dementia with Psychosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F02.81.
Impact
Clinical: May lead to inappropriate treatment plans., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to insufficient documentation.
Mitigation Strategy
Train staff on the importance of detailed symptom documentation., Use templates that prompt for onset details.
Impact
Reimbursement: May lead to lower reimbursement due to lack of specificity., Compliance: Non-compliance with coding guidelines for specificity., Data Quality: Reduces the accuracy of health records and data analytics.
Mitigation Strategy
Ensure documentation specifies the type and severity of dementia and any behavioral disturbances.
Impact
Risk of audits due to use of unspecified dementia codes.
Mitigation Strategy
Ensure documentation supports the use of specific codes by detailing symptoms and their onset.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Dementia with Psychosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Dementia with Psychosis
Use these documentation templates to ensure complete and accurate documentation for Dementia with Psychosis. These templates include all required elements for proper coding and billing.
Dementia with Psychosis in Alzheimer's Disease
Specialty: NeurologyRequired Elements
- Diagnosis of Alzheimer's disease
- Description of psychotic symptoms
- Onset and progression of symptoms
- Assessment tools used
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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