What ICD‑10‑CM code should be used for a family history of Alzheimer’s disease?

ICD-10-CM Code for Family History of Alzheimer's Disease

The ICD-10-CM code for family history of Alzheimer's disease is Z82.0 (Family history of epilepsy and other diseases of the nervous system), which encompasses family history of dementia including Alzheimer's disease.

Understanding the Code Structure

• The Z82 category in ICD-10-CM specifically covers family history of certain disabilities and chronic diseases leading to disablement 1
• Z82.0 is the appropriate code when documenting a patient's family history of Alzheimer's disease or other neurological conditions 1
• This code is used for documentation purposes and risk stratification, not for diagnosis of the patient themselves 1

Clinical Context and Risk Assessment

• A family history of Alzheimer's disease at least doubles the lifetime risk from the general population baseline of 10-12% over a 75-80 year lifespan 2
• Approximately 15-25% of Alzheimer's cases show familial clustering, while 75% are considered sporadic 3
• The accuracy of patient-reported family history of Alzheimer's disease is approximately 84% when verification is possible through medical records 4

When Additional Codes May Be Needed

• If the patient has a maternal family history specifically, this carries additional significance as maternal family history is associated with greater Alzheimer's disease biomarker burden, though the same Z82.0 code applies 5
• If genetic testing reveals specific mutations (PSEN1, PSEN2, or APP), additional codes for genetic carrier status may be appropriate in conjunction with Z82.0 3
• For patients with early-onset Alzheimer's disease in the family (before age 60-65), the same Z82.0 code is used, but documentation should specify the age of onset for risk assessment purposes 3

Documentation Best Practices

• Obtain a detailed 3-generation family history with specific attention to age of onset of neurologic symptoms, type of dementia, and method of diagnosis 3
• Medical records should be used to confirm Alzheimer's disease diagnosis in family members when feasible, as this improves accuracy from patient report alone 4
• Document whether the family history suggests autosomal dominant (≥3 individuals in 2+ generations), familial (≥2 affected third-degree relatives or closer), or sporadic patterns, as this impacts genetic counseling recommendations 3