ICD-10-CM F02.82: Dementia with Psychotic Disturbance
ICD-10-CM code F02.82 denotes dementia in other diseases classified elsewhere, unspecified severity, with psychotic disturbance. It is crucial for accurate diagnosis and documentation, focusing on the presence of psychotic symptoms like delusions or hallucinations, alongside cognitive decline. Comprehensive documentation should include detailed patient history, symptomatology, and any impact on daily functioning, ensuring compliance with CMS guidelines.
Overview
F02.82 refers to dementia that occurs as a result of other diseases not specifically classified under dementia categories, characterized by unspecified severity and the presence of psychotic disturbances such as hallucinations or delusions. This code is often used when dementia is secondary to conditions like Parkinson's disease, Huntington's disease, or other neurodegenerative disorders. Patients may exhibit cognitive impairments affecting memory, reasoning, and judgment, alongside behavioral symptoms that can include agitation, aggression, and mood swings. The psychotic disturbances complicate the clinical picture, requiring careful assessment and management. Accurate coding is essential for appropriate treatment planning and resource allocation, as well as for understanding the broader implications of dementia in the context of other underlying health issues.
Coding Complexity
Rating: Medium
Factors:
- Differentiating between primary and secondary dementia
- Identifying the underlying disease causing dementia
- Assessing the severity of psychotic disturbances
- Documenting cognitive assessments accurately
- Understanding the interplay between dementia and other comorbid conditions
Comparison:
Compared to codes for primary dementia (e.g., Alzheimer's disease), F02.82 is more complex due to the need to identify and document the underlying disease. Primary dementia codes typically focus solely on cognitive decline without the added layer of psychotic symptoms, making them easier to code.
Audit Risk Factors:
- Inadequate documentation of the underlying disease
- Failure to specify the severity of psychotic disturbances
- Misclassification of dementia type
- Lack of comprehensive cognitive assessment results
- Inconsistent use of terminology in clinical notes
Specialty Focus
- Specialty: Neurology
Documentation Requirements: Detailed neurological assessments, cognitive testing results, and documentation of psychotic symptoms.
Common Clinical Scenarios: Patients with Parkinson's disease presenting with cognitive decline and hallucinations.
Special Considerations: Neurologists must ensure that the underlying disease is clearly documented to support the use of F02.82. - Specialty: Psychiatry
Documentation Requirements: Psychiatric evaluations, including mental status examinations and assessments of psychotic symptoms.
Common Clinical Scenarios: Patients with dementia exhibiting severe behavioral disturbances requiring psychiatric intervention.
Special Considerations: Psychiatrists should document the impact of psychotic symptoms on the patient's daily functioning.
Coding Guidelines
According to ICD-10 guidelines, F02.82 should be used when dementia is a consequence of another disease and is accompanied by psychotic disturbances. Coders must ensure that the underlying condition is documented and that psychotic symptoms are clearly noted.
Related CPT Codes
- Code: 96116
Procedure Name: Neuropsychological testing
Clinical Scenario: Used to assess cognitive function in patients with suspected dementia.
Documentation Requirements: Results of cognitive assessments must be documented.
Specialty Considerations: Neurologists and psychologists should collaborate on documentation.
Billing Information
Billing for services related to F02.82 requires comprehensive documentation of the patient's cognitive assessments, underlying conditions, and any psychotic symptoms present.
Additional Resources
Related CPT Codes
Helpful links for mental health billing and documentation
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Q: What documentation is necessary for ICD-10-CM F02.82?
For ICD-10-CM code F02.82, documentation should reflect comprehensive clinical evaluation, specifying the type and severity of dementia and describing psychotic features, such as delusions or hallucinations. Documentation must include relevant patient history, cognitive assessment results, and a detailed description of symptoms impacting daily living. Cognitive and behavioral status should be regularly monitored and recorded. Diagnostic tests and assessment scales used must be noted, ensuring all information complies with CMS requirements to support the diagnosis.
Q: How does ICD-10-CM F02.82 differ from other dementia codes?
ICD-10-CM F02.82 specifically addresses dementia cases where psychotic disturbances such as hallucinations or delusions are present, in diseases classified elsewhere. Unlike other dementia codes, which might highlight primary symptoms of cognitive decline without psychotic features, F02.82 requires documentation of these additional symptoms. This specificity aids in differentiating the patient's condition for appropriate care planning and aligns with billing and compliance standards, as psychotic disturbances can significantly influence management strategies.
Q: What are common psychotic symptoms in dementia related to F02.82?
In the context of ICD-10-CM F02.82, common psychotic symptoms include delusions—fixed, false beliefs—and hallucinations, typically auditory or visual. These symptoms can exacerbate cognitive decline, causing distress and complicating patient management. Documentation should accurately describe symptom onset, frequency, and impact on the patient's quality of life. Noting the presence of these symptoms is essential for care planning and can guide differential diagnosis among other neurocognitive disorders.
Q: Why is accurate coding critical for psychotic disturbance in dementia?
Accurate coding with ICD-10-CM F02.82 ensures proper classification of dementia with psychotic features, which affects treatment planning and resource utilization. Precise documentation and coding are vital for billing accuracy, audit compliance, and reflecting the patient's clinical complexity. This precision also facilitates effective communication between healthcare providers, ensuring the delivery of coordinated care. Omission of relevant psychotic features may result in mismanaged treatment strategies or inadequate reimbursement.
Q: What challenges might a clinician face when documenting F02.82?
Clinicians documenting F02.82 must thoroughly evaluate the cognitive and psychotic symptoms, ensuring descriptions align with ICD-10-CM criteria. The interplay between cognitive decline and psychotic symptoms can complicate diagnosis and documentation. Accurate differentiation from other psychiatric disorders is essential. Regular updates to patient records reflecting symptom progression and periodic reassessments are required. Challenges include maintaining detailed records of symptom impact, adherence to CMS documentation standards, and reconciling input from multi-disciplinary care teams.