News: Parkinson’s indexing off, says Coding Clinic

The newly released Coding Clinic, Second Quarter, 2017, touches on diagnoses related to neurology such as Parkinson’s disease, encephalopathy, and stroke, as well as questions related to nicotine and drug dependence, among other items, some of which previously lead to discrepancies amongst auditors, says Sharme Brodie, RN, CCDS, CDI education specialist and CDI Boot Camp instructor for HCPro in Middleton, Massachusetts.

Let’s start with dementia due to Parkinson’s disease. Other recent Coding Clinic concerns will be explored in an upcoming edition of the CDI Journal.

Parkinson’s is a neurodegenerative brain disorder that progresses slowly. Symptoms include ongoing loss of motor control (resting tremors, stiffness, slow movement, and postural instability), as well as a wide range of non-motor symptoms such as depression, loss of sense of smell, gastric problems, cognitive changes, and more. Although not fatal, most individuals diagnosed will die from complications related to the disease. The average age of diagnosis is 60, but approximately 15% of people with Parkinson’s are diagnosed prior to age 50 and are said to have young-onset Parkinson’s.

While the disease is sometimes known by other names, including Parkinsonism, parkinsonism is a general term that refers to a group of neurological disorders that cause movement problems like those seen in Parkinson’s but it is attributed to toxins, drugs, brain injury or infection, or neurodegenerative disease.

Coding Clinic clarifies that indexing included in the ICD-10-CM coding manual could cause incorrect code assignment, according to Allen Frady, RN, BSN, CCS, CCDS, CDI education specialist and CDI Boot Camp instructor for HCPro in Middleton, Massachusetts, and this edition indicates that the Centers for Disease Control, is aware of the situation and is considering updates to the code set.

So, for now, Coding Clinic recommends assigning code G20, Parkinson’s disease, and F02.81, Dementia in other diseases classified elsewhere with behavioral disturbance, for a patient with Parkinson’s dementia exhibiting aggressive behavior, says Brodie.