ICD-10 Coding for Severe Dementia(F01.C11, F02.C11)
Complete ICD-10-CM coding and documentation guide for Severe Dementia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Severe Dementia
F01-F03Primary Range
Mental and behavioral disorders due to known physiological conditions
This range includes codes for different types of dementia, specifying severity and behavioral disturbances.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| F01.C11 | Vascular dementia, severe, with agitation | Use when severe vascular dementia is accompanied by agitation. |
|
| F02.C11 | Dementia in Alzheimer's disease, severe, with agitation | Use when severe dementia is due to Alzheimer's disease with agitation. |
|
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 severe dementia with agitation
Essential facts and insights about Severe Dementia
Primary ICD-10-CM Codes for severe dementia
Decision Criteria
clinical Criteria
- Presence of severe cognitive impairment and agitation
documentation Criteria
- Explicit mention of 'severe' and 'agitation' in clinical notes
Applicable To
- Severe vascular dementia with behavioral disturbances
Excludes
- Alzheimer's disease (G30.-)
Clinical Validation Requirements
- Neuroimaging evidence of cerebrovascular disease
- Documentation of severe cognitive impairment and agitation
Code-Specific Risks
- Failure to document severity and behavioral disturbance can lead to incorrect coding.
Coding Notes
- Ensure documentation specifies both severity and type of behavioral disturbance.
F02.C11 - Dementia in Alzheimer's disease, severe, with agitation
Use when severe dementia is due to Alzheimer's disease with agitation.
Applicable To
- Severe Alzheimer's dementia with behavioral disturbances
Excludes
- Vascular dementia (F01.-)
Clinical Validation Requirements
- Confirmation of Alzheimer's disease etiology
- Documentation of severe cognitive impairment and agitation
Coding Notes
Ensure Alzheimer's disease is documented as the underlying cause.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Wandering in diseases classified elsewhere
Z91.83Differential 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 Severe Dementia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F01.C11.
Impact
Clinical: Inaccurate representation of patient condition., Regulatory: Non-compliance with coding standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Use templates that prompt for severity, Regular training on documentation standards
Impact
Reimbursement: May lead to lower DRG payment if severity is unspecified., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate data affecting patient care and reporting.
Mitigation Strategy
Ensure documentation explicitly states 'severe' and any behavioral disturbances.
Impact
Failure to document severity can lead to audit discrepancies.
Mitigation Strategy
Implement mandatory fields in EHR for severity documentation.
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 Severe Dementia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Severe Dementia
Use these documentation templates to ensure complete and accurate documentation for Severe Dementia. These templates include all required elements for proper coding and billing.
Severe Dementia with Agitation
Specialty: NeurologyRequired Elements
- Severity of dementia
- Type of behavioral disturbance
- Underlying cause of dementia
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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