Neurology & Pain Management Coding Alert

Question: Encounter notes indicate that the provider treated a patient with mild vascular dementia with behavioral disturbance. What are the different types of behavioral disturbances, and how do I choose an ICD-10 code for this patient?

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Answer: You’ll have several different options for your mild vascular dementia patient; you will, however, need more information from the notes before you can report a code from the F01.A- (Vascular dementia, mild) code set.

Go back and check the notes for information on the type of behavioral disturbance the patient is suffering; then choose one of the following diagnosis codes (The notes describing each type of disturbance are listed here for easier differentiation):

• F01.A0 (Vascular dementia, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety)
  • Major neurocognitive disorder due to vascular disease, mild, NOS
  • Vascular dementia, mild, NOS
• F01.A11 (Vascular dementia, mild, with agitation)
  • Major neurocognitive disorder due to vascular disease, mild, with aberrant motor behavior such as restlessness, rocking, pacing, or exit-seeking
  • Major neurocognitive disorder due to vascular disease, mild, with verbal or physical behaviors such as profanity, shouting, threatening, anger, aggression, combativeness, or violence
  • Vascular dementia, mild, with aberrant motor behavior such as restlessness, rocking, pacing, or exit-seeking
  • Vascular dementia, mild, with verbal or physical behaviors such as profanity, shouting, threatening, anger, aggression, combativeness, or violence
• F01.A18 (Vascular dementia, mild, with other behavioral disturbance)
  • Major neurocognitive disorder due to vascular disease, mild, with behavioral disturbances such as sleep disturbance, social disinhibition, or sexual disinhibition
  • Vascular dementia, mild, with behavioral disturbances such as sleep disturbance, social disinhibition, or sexual disinhibition
• F01.A2 (Vascular dementia, mild, with psychotic disturbance)
  • Major neurocognitive disorder due to vascular disease, mild, with psychotic disturbance such as hallucinations, paranoia, suspiciousness, or delusional state
  • Vascular dementia, mild, with psychotic disturbance such as hallucinations, paranoia, suspiciousness, or delusional state

• F01.A3 (Vascular dementia, mild, with mood disturbance)

  • Major neurocognitive disorder due to vascular disease, mild, with mood disturbance such as depression, apathy, or anhedonia

  • Vascular dementia, mild, with mood disturbance such as depression, apathy, or anhedonia

• F01.A4 (Vascular dementia, mild, with anxiety)

  • Major neurocognitive disorder due to vascular disease, mild, with anxiety.