Partnership Guide 2023Dementia

For an on-demand webinar, click here or navigate to MedicareProviders.Cigna.com > Provider Education > Disease-Specific Training.Documentation and Coding for Dementiaimg1Documentation ConsiderationsIn addition to presenting signs and symptoms, the documented exam findings should include results of standardized cognitive testing, such as the Functional Assessment Staging Test or Montreal Cognitive Assessment.Advanced imaging can show brain activity patterns, protein deposits, and other structural changes that can assist in diagnosis and treatment.Laboratory testing can be performed to determine other physiological causes of impairment.Treatment plans include medications, occupational therapy, lifestyle changes (diet and exercise), and assisted care.img2Coding Considerations

Additional classifications to specify status of onset

Early onset: occurring before age 65
Late onset: occurring after age 65

Use appropriate additional code when delirium is present

Use appropriate additional code to identify:

Dementia with behavioral disturbance
Dementia without behavioral disturbance
Any associated diagnosis such as Parkinson’s disease, Lewy bodies, etc.
Presence of delirium

img3Example*Diagnostic statement: Early onset Alzheimer’s disease with agitation and aberrant motor behaviorCoded as:G30.0 - Alzheimer’s disease with early onsetF02.811 – Dementia in other diseases classified elsewhere, unspecified severity, with agitation* The sole purpose of the examples is to demonstrate the application of coding guidelines discussed in the materials. Examples do not represent complete documentation of a condition, nor provide any clinical advice. Each patient and medical record is unique, and assignment of codes depends solely on the distinct documentation within an individual record.Providers must confirm the accuracy of their diagnoses to ensure that diagnosis and coding practices comply with ICD-10-CM Official Guidelines for Coding and Reporting and all applicable legal requirements. Failure to address diagnosis inaccuracies can result in administrative sanctions and potential financial penalties. Accurate coding and submission activities allow us to provide the best benefits and resources possible to our customers.This guide is informational and not meant to replace the clinician’s judgment when caring for the patient. Content updated April 20232023 Medicare Advantage Partnership GuideWelcomeContentsDocumentation Best Practices2023 Medicare Advantage ICD-10-CM Quick Reference Code GuideDisease-Specific Webinar LinksConditioning Reporting GuideReporting Common ConditionsAtrial FibrillationCancerChronic Kidney Disease (CKD)Chronic Obstructive Pulmonary Disease (COPD)Congestive Heart Failure (CHF)DVT and PEDementiaDiabetes Mellitus (DM)Major DepressionObesityPeripheral Artery Disease (PAD)Substance Use/Abuse/DependenceTobacco and E-Cigarette Use/AbuseSocial Determinants of Health