Wiki Manifestation Codes

[KZuppinger]

Hi-

I have a chart where the px has been diagnosed with Lewy Body Dementia. I coded it with the G31.83 code followed by the F02.80 code. The documentation does not state whether or not the condition exist with or without behavioral disturbance and I cannot query the provider. So my auditor asked that I remove the F02.80 code. I thought this code is mandatory if it is in brackets. She says it only applies "if applicable" And since I don't knowif the px has a behavioral disturbance or not, I have to remove the F02.80 code.

Can someone weigh in on this and let me know if my interpretation is correct? Or if my auditors interpretation is correct.

 

[cathya35]

I believe you are correct

I believe you are correct in that both G31.83 and F02.80 are needed.

If you look at the tabular, code G31.83 has the instruction to
"Use additional code to identify:
dementia with behavioral disturbance (F02.81)
dementia without behavioral disturbance (F02.80):

Code F02.80 also has the instruction to "Code First: dementia with Lewy bodies (G31.83)"