Author: Keisha Wilson CCS, CPC, CRC, CPB, CPMA, AAPC Approved Instructor
April is Parkinsons Awareness Month! Approximately 10 million people in the world have Parkinson’s. Parkinson’s disease is a chronic, progressive, systemic and debilitating neurodegenerative condition of the brain with symptoms such as tremors, movement and balance difficulties, and a wide range of associated manifestations such as:
- Sleep disorders
- Cognitive impairment and dementia
- Depression
- Anxiety
- Visual disturbances
- Chronic Pain
- Loss of smell
- Urinary Dysfunction
- Sexual dysfunction
Reviewing the provider’s documentation is essential to identify any manifestations noted in the health record, allowing for proper code assignment of ICD-10-CM diagnosis codes. Therefore, sequencing Parkinson’s disease is vital and can reveal an accurate patient picture of the patient’s condition; “code first” and “use additional code” notes are used as sequencing rules in the classification for certain diagnosis codes.
Per ICD-10- CM, an example of the etiology/manifestation convention is dementia with Parkinson’s disease. Code G20 is listed first in the Alphabetic Index, followed by code F02.80 or F02.81- in brackets. Code G20 represents the underlying etiology, Parkinson’s disease, and must be sequenced first, whereas codes F02.80 and F02.81- represent the manifestation of dementia in diseases classified elsewhere, with or without behavioral disturbance.
Parkinson’s disease code is found in Chapter 6 of the ICD-10 CM, Diseases of the Nervous System (G00-G99). ICD-10-CM code G20 presents Parkinson’s Disease, with 5 additional codes added in 2023:
- Behavioral Disturbance (F02.81-, F02.A1-, F02.B1-, F02.C1X)
- Dementia w/ Mood Disturbance (F02.83, F02.A3, F02.B3, F02.C3)
- Dementia w/ Psychotic Disturbance (F02.82, F02.A2, F02.B2, F02.C2)
- Dementia w/ Behavioral Disturbance (F02.80, F02.A0, F02.B0, F02.C0)
- Mild Neurocognitive Disorder Due to Known Physiological Condition (F06.7X)
Documentation of the patient’s reactions to the medication, side effects of treatment, disease progression or regression and any other social and economic factors (Social Determinants of Health) is also vital, not only for code assignment but the medical necessity and continued treatment of the patient’s condition. Parkinson’s research continues to advance with new opportunities. That includes different approaches to treat the full spectrum of PD, from early diagnosis to advancing disease.
To schedule training on documentation and coding guidelines for your organization or private practice providers, email us today at info@kwadvancedconsulting.com, schedule a call or visit the website and fill out the “contact us” form.
Resources:
https://www.cms.gov/files/document/fy-2023-icd-10-cm-coding-guidelines-updated-01/11/2023.pdf
