What are the ICD-10 (International Classification of Diseases, 10th Revision) codes for dementia?

ICD-10 Codes for Dementia

The primary ICD-10 codes for dementia include F00-F03 for dementia in the mental disorders chapter, with additional codes from other chapters to specify etiology and manifestations. 1

Main Dementia Codes

Dementia in Alzheimer's Disease (F00)

• F00.0 - Dementia in Alzheimer's disease with early onset
• F00.1 - Dementia in Alzheimer's disease with late onset
• F00.2 - Dementia in Alzheimer's disease, atypical or mixed type
• F00.9 - Dementia in Alzheimer's disease, unspecified

Vascular Dementia (F01)

• F01.0 - Vascular dementia of acute onset
• F01.1 - Multi-infarct dementia
• F01.2 - Subcortical vascular dementia
• F01.3 - Mixed cortical and subcortical vascular dementia
• F01.8 - Other vascular dementia
• F01.9 - Vascular dementia, unspecified

Dementia in Other Diseases (F02)

• F02.0 - Dementia in Pick's disease
• F02.1 - Dementia in Creutzfeldt-Jakob disease
• F02.2 - Dementia in Huntington's disease
• F02.3 - Dementia in Parkinson's disease
• F02.4 - Dementia in HIV disease
• F02.8 - Dementia in other specified diseases classified elsewhere

Unspecified Dementia (F03)

• F03 - Unspecified dementia

Additional Coding Considerations

Severity Coding

When coding dementia, severity should be specified when possible 2:

• Stage 3: Mild Cognitive Impairment
• Stage 4: Mild Dementia
• Stage 5: Moderate Dementia
• Stage 6: Severe Dementia

Behavioral and Psychological Symptoms

For behavioral and psychological symptoms of dementia (BPSD), additional codes may be used 2:

• F06.0 - Organic hallucinosis
• F06.2 - Organic delusional disorder
• F06.3 - Organic mood disorder
• F06.4 - Organic anxiety disorder
• F06.8 - Other specified mental disorders due to brain damage and dysfunction

Lewy Body Dementia

• G31.83 - Dementia with Lewy bodies (Note: This is from the neurological disorders chapter)

Frontotemporal Dementia

• G31.09 - Frontotemporal dementia (Note: This is from the neurological disorders chapter)

Coding Challenges and Best Practices

1. Dual Coding Required: In ICD-10, dementia requires both a code from the mental disorders chapter (F00-F03) and an additional code to specify the underlying etiology from another chapter 1, 3.

2. Under-coding Issue: Research has shown significant under-coding of dementia in hospital settings, which impacts planning for treatments and service provision 3.

3. Interpretation Variations: There have been discrepancies in interpreting ICD-10 dementia criteria, particularly regarding cognitive domains that must be impaired 4.

4. Diagnostic Accuracy: When properly interpreted, ICD-10 criteria can achieve high agreement with other diagnostic systems like DSM-IV 4.

5. Mixed Etiology: For patients with multiple contributing factors to dementia (common in older adults), consider coding for mixed etiology dementia 2.

6. Documentation Requirements: Ensure documentation includes:

   • Specific type of dementia
   • Severity level
   • Behavioral and psychological symptoms
   • Functional impairments
   • Contributing factors

Clinical Staging Correlation

When determining the appropriate ICD-10 code, consider clinical staging tools that can help document severity 2, 5:

• CDR (Clinical Dementia Rating) scale: 0-3
• GDS-Reisberg stage: 1-7
• MMSE score ranges for dementia: 0-22
• MoCA score ranges

Remember that accurate coding is essential for proper patient care planning, research, and healthcare resource allocation. The complexity of dementia coding requires attention to both the cognitive syndrome and its underlying etiology 6.