New Dementia ICD-10 Codes – October 1, 2022
An expansion of the dementia codes was requested in the Center for Disease Control’s (CDC) ICD-10-CM Coordination and Maintenance Committee Meeting, During this meeting, The National Minority Quality Forum (NMQF) requested an inclusion of the stage and severity and identification of behavioral and psychological symptoms of dementia. According to the NMFQ, the factors are pivotal for effective patient management strategies. The 2023 ICD-10 code set includes 100 new codes that facilitate reporting conditions including vascular dementia (F01.5-F01.C4), dementia in other diseases (F02.8-F02.C4), and unspecified dementia (F03.9-F03.C4).
Furthermore, the new guidelines emphasize on documenting the severity of the patient’s condition. The updated guidelines require the coder to either query the provider or default to the appropriate unspecified code if the documentation is incomplete. Similarly, the coder is required to assign the highest severity level, if a patient with dementia admitted to an inpatient facility get worse during their stay. The Committee further elucidated the following clarifications for determining the dementia stage.
Mild Dementia:
“Clearly evident functional impact on daily life, affecting mainly instrumental activities. No longer fully independent/requires occasional assistance with daily life activities.”
Moderate Dementia:
“Extensive functional impact on daily life with impairment in basic activities. No longer independent and requires frequent assistance with daily life activities.”
Severe Dementia:
“Clinical interview may not be possible. Complete dependency due to severe functional impact on daily life with impairment in basic activities, including basic self-care.”
A few of the specific billable dementia codes in SNFs include:
- F03.90, Unspecified dementia, unsp severity, without beh/psych/mood/anx
- F03.91, should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail.
- F03.911, Unspecified dementia, unspecified severity, with verbal or physical behaviors such as profanity, shouting, threatening, anger, aggression, combativeness, or violence
- F03.918, Unspecified dementia, unspecified severity, with behavioral disturbances such as sleep disturbance, social disinhibition, or sexual disinhibition
- F03.92, Unspecified dementia, unspecified severity, with psychotic disturb
- F03.93, Unspecified dementia, unspecified severity, with mood disturbance such as depression, apathy, or anhedonia
No two residents with dementia are the same
In conclusion to the changes in the Dementia ICD-10 Codes, no two patients with dementia are the same. The revised codes are specifically linked to the severity of the disease. Whereas there was a lack of additional detail on key associated disorder, especially psychotic and mood disorders, and anxiety in the previous. Read more about the changes here: 2023 ICD-10-CM Diagnosis Code F03.90: Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety at ICD10data.com (icd10data.com)
The codes are to be used for discharges occurring from October 1, 2022, through September 30, 2023.
Disclaimer: Always refer to the latest CDC ICD-10 Guidelines & your facility policy & procedures.
(SNF = Skilled Nursing Facilities)
Written by: Aiman Shahab DNS, – SNF Content Writer
