Neurosurgery Coding Alert

Question: A patient who suffers from mild vascular dementia has exhibited some aggressive physical behaviors: shouting at family, threatening behavior, and unusual aggression. Is there a way to code for these behaviors?

Massachusetts Subscriber

Answer: There is now, thanks to the expansion of the vascular dementia section of ICD-10. In 2023, ICD-10 updated this section of the code book to include different types of behavioral challenges that can accompany vascular dementia.

For this patient, you’d report F01.A11 (Vascular dementia, mild, with agitation). According to ICD-10, agitation includes behaviors such as:

• Aberrant motor behavior such as restlessness, rocking, pacing, or exit-seeking
• Verbal or physical behaviors such as profanity, shouting, threatening, anger, aggression, combativeness, or violence
• Aberrant motor behavior such as restlessness, rocking, pacing, or exit-seeking
• Verbal or physical behaviors such as profanity, shouting, threatening, anger, aggression, combativeness, or violence

Here’s a quick peek at the other types of behavioral challenges you can report for your mild vascular dementia patients:

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.