Select Page

In the long-term care industry, few challenges are as profound as caring for people with dementia symptoms. And proper documentation and accurate dementia ICD 10 coding are paramount in meeting regulations, providing adequate care, ensuring accurate reimbursements, and reducing dementia-related stigma. 

A physician is able to provider better care to a resident because the facility implements accurate dementia ICD-10 codes.
Accurate dementia ICD-10 coding is crucial for meeting regulations, providing adequate care, and reducing dementia-related stigma.

Before we explore dementia ICD-10 coding, though, we will first examine dementia in the long-term care context. Unfortunately, it has increased substantially, with approximately seven million seniors (age 65 or older) diagnosed with dementia in 2020. This condition, often marked by memory loss, impairs reasoning, causes personality changes, and requires meticulous care and attention from healthcare professionals, who must document all diagnosis details and treatment. 

Dementia ICD-10 codes are a means to improve communication between caregivers, healthcare providers, insurers, and policymakers. They are used for accurate documentation and for the purpose of reimbursement. They also help to reduce the stigma surrounding dementia as people gain a better understanding of the condition. 

The International Classification of Diseases, 10th Revision, or ICD-10, is a standardized system that categorizes and codes diseases, conditions, medical procedures, and reimbursements. The codes offer a globally-understood language that manages health statistics while streamlining communication among healthcare professionals, researchers, and policymakers.

ICD-10 codes for dementia serve as guidelines that ensure appropriate care and management. They reflect a wide array of dementia subtypes and stages to differentiate between Alzheimer’s disease, vascular dementia, Lewy body dementia, and other variants. 

This specialized coding system allows caregivers to provide personalized care and adequate treatment through proper documentation via long-term care software systems. So, in our next section, we will explore different ICD-10 codes, the importance of using nursing computer software to improve coding, and the impact on resident outcomes. 

What Is an ICD 10 Code for Dementia?

As mentioned, the ICD-10 coding system is a vital tool healthcare professionals use to categorize and document medical diseases and conditions accurately. Dementia is a neurological condition with various forms and complexities, and there is a specific subset of the ICD 10 code for dementia that reflects these conditions.

Here are the most common dementia ICD-10 codes grouped by category: 

Alzheimer’s Disease (AD): Alzheimer’s disease accounts for 60% to 80% of dementia cases in America. It emerges from a combination of genetic, lifestyle, and environmental factors that impact brain cells, ultimately leading to the gradual erosion of memory and cognitive function. The ICD-10 coding for Alzheimer’s is reflected in four primary codes for this condition:

  • G30.0 – Alzheimer’s disease with early onset
  • G30.1 – Alzheimer’s disease with late onset
  • G30.9 – Other Alzheimer’s disease
  • G30.9 –  Alzheimer’s disease unspecified

A secondary classification of codes is used to highlight other variants, like dementia variations that lack behavioral disturbances. For example, F02.80 describes dementia in other diseases without behavioral disturbance, while F02.81 represents dementia within other classified conditions with behavioral disturbances.

Vascular Dementia (VaD): This prevalent form of dementia is caused by a stroke that disrupts the brain’s blood flow, leading to blocked blood vessels. The condition usually manifests itself through mild thinking difficulties that progressively worsen and become small strokes. Vascular brain changes often coexist with other types of dementia, such as Alzheimer’s disease and dementia with Lewy bodies.

In addition to memory loss, this type of dementia manifests with challenges in problem-solving, thinking speed, concentration, and organizational skills. There are two ICD-10 codes dedicated to vascular dementia:

  • F01.50 – Vascular dementia without behavioral disturbances
  • F01.51 – Vascular dementia with behavioral disturbances

Within the ICD-10 framework, emphasizing and reporting the underlying physiological condition of a resident with vascular dementia is of utmost importance. This is because behavioral disturbances (F01.51) are assigned an additional code (Z91.83) to help caregivers identify incidents of “wandering” and thus improve the accuracy of diagnostic reporting.

Lewy Body Dementia (LBD): This form of dementia is characterized by a gradual decline in cognitive functions, reasoning abilities, and self-sufficiency. The underlying cause of LBD lies in abnormal deposits of a protein in the brain that damages brain cells called alpha-synuclein. Key symptoms include:

  • Changes in thinking
  • Disruptions in sleep patterns
  • Increased delusions and hallucinations
  • Fluctuations in alertness 
  • Inconsistent confusion throughout the day 

Motor symptoms, such as slowness, tremors, and other Parkinson’s symptoms (rigid muscles, impaired posture and balance, loss of automatic movements, and speech and writing changes) are also common manifestations.

The ICD-10 code assigned to dementia with Lewy bodies is G31.83, which also has several synonymous terms, including:

A caregiver is making sure a resident in a long-term care facility is given adequate care after checking the accuracy of her ICD 10 code for dementia.
An ICD 10 code for dementia is a specific subset of ICD codes that reflects neurological conditions.
  • Diffuse Lewy body disease
  • Lewy body dementia with or without behavioral disturbance
  • Senile dementia of the Lewy body type

The code G31.83 is also used to determine:

  • Cases of dementia with Parkinson’s and Lewy body disease
  • MS-DRG (Medicare Severity-Diagnosis Related Group) assignment 
  • MS-DRG 056 – Degenerative nervous system disorders with MCC (Major Complication or Comorbidity)
  • MS-DRG 057 – Degenerative nervous system disorders without MCC

Frontotemporal Dementia (FTD): This is sometimes referred to as frontotemporal disorder, which results from damaged neurons in the frontal and temporal lobes of the brain. While FTD is rare, it tends to occur earlier than other forms of dementia, with approximately 60% of people developing FTD between 45 to 64 years old.

FTD is a progressive disease that affects a person’s behavior, personality, and language abilities. As the disease progresses, a person’s symptoms may become more prevalent. It is difficult to pinpoint FTD symptoms because they vary from person to person. They can also appear across different disorders and vary at different stages of the disease when different brain parts are affected. 

The ICD-10 code for frontotemporal dementia is G31.09. In cases involving behavioral disturbances, an additional code, F02.81, is used to determine the exact dementia details, including disturbances. This dual-coded approach ensures healthcare providers and caregivers accurately document and communicate the patient or resident’s symptoms and needs. 

Mixed Dementia: Sometimes, people have a combination of dementia types and symptoms. Their symptoms vary depending on which type of dementia is more dominant. Since there is no specific code for mixed dementia, healthcare providers can turn to curated ICD-10 documentation for further guidance on Alzheimer’s or other types of dementia for correct coding.

Primary vs. secondary dementia differentiation

One key of ICD-10 coding is differentiating between primary and secondary forms of dementia. Primary dementia, such as Alzheimer’s, stems from specific neurodegenerative processes, while secondary dementia often results from other underlying conditions, such as Huntington’s disease, Parkinson’s disease, or depression. 

By paying attention to the distinctions in these codes, healthcare providers can identify the root causes of cognitive decline and devise tailored treatment plans. An accurate diagnosis can provide patients with critical information, resources, and support to enhance their well-being. It also allows patients to explain the changes in their lives to their family and friends and allows them to make pragmatic decisions on their financial circumstances or to establish power of attorney.

Patients diagnosed with dementia can also actively prepare their homes to allow for more independence and the opportunity to utilize home health services in order to avoid moving into a long-term care facility. This enriches the quality of life for people with dementia and their caregivers while decreasing expenses. 

Precise ICD coding also contributes to epidemiological research, policy formulation, and healthcare planning. Accurately classified healthcare data gives researchers and policymakers what they need to understand dementia’s prevalence, impact, and trends comprehensively. This information is invaluable for shaping strategies to combat this growing challenge.

Contact us here to learn how our long-term care software can improve your ICD-10 coding accuracy.

“Is Dementia a Mental Illness?” Understanding the Stigma

“Is dementia a mental illness?” This question often arises when discussing the complexities of cognitive decline, especially in the context of long-term care. While it’s common for people to associate dementia with mental health issues, it is crucial to clarify that dementia is, in fact, a neurodegenerative disorder and not a mental illness. 

Here, we will explain the distinction between mental illnesses and neurological disorders while reducing the stigma around dementia. Indeed, it is clear from dementia ICD 10 codes that the ICD-10 codes for dementia and symptoms of dementia describe a range of cognitive impairments that affect memory, thinking, and daily functioning. And these stem from neurological damage and the connections between brain cells.

Unlike mental illnesses, which primarily involve mood, behavior, or cognitive disturbances. The ICD 10 code for dementia is characterized by progressive and irreversible deterioration of cognitive abilities. Understanding this distinction is essential in ensuring that individuals with dementia receive appropriate care and support tailored to their needs.

Unfortunately, despite a clear distinction between the two conditions, there is still a lot of stigma surrounding people with dementia, and it impacts their quality of life. Some of the biggest barriers created around people with dementia include:

  • False beliefs, negative attitudes, and discriminatory behavior directed toward those with dementia
  • Negative attitudes toward friends, families, and caregivers of people with dementia
  • Unrealistic associations of people living with dementia, for which there is no cure or guaranteed form of prevention 
  • Negative labels and names

By recognizing dementia as a neurodegenerative disorder and understanding the specific ICD code for Alzheimer’s dementia, we can remove the stigma and stereotypes that are significant obstacles impeding the well-being and quality of life of those with dementia and their families. 

This shift fosters empathy, understanding, and better communication between caregivers, healthcare professionals, and families, giving individuals with dementia the dignity and compassion they deserve.

6 Ways Long-Term Care Software Utilizes Dementia ICD 10 Codes

ICD-10 codes facilitate accurate diagnosis, research, and conversations, ultimately reducing stigma by promoting understanding, empathy, and appropriate care for individuals with dementia. By using specific dementia ICD 10 codes in a long-term care software system, we can help pave the way for a more compassionate, informed, and stigma-free approach to caregiving. 

Below, we have highlighted the most significant ways long-term care software can seamlessly incorporate dementia ICD 10 codes to revolutionize and improve dementia care and even help remove the stigma associated with this condition:

A caregiver is speaking with a resident in a nursing home and discussing the topic of: "Is dementia a mental illness?"
“Is dementia a mental illness?” Dementia is a neurodegenerative disorder and not a mental illness.
  1. Proper documentation and communication: Long-term care software can integrate ICD-10 codes for dementia into patient records and assessments. Using standardized codes, caregivers, nurses, and medical professionals can accurately document and communicate the condition. This consistent and precise documentation helps to legitimize dementia as a medical concern, reducing the likelihood of attributing symptoms solely to aging and dispelling misconceptions.
  2. Person-centered care plans: Elder care software can use ICD-10 codes to create personalized care plans for individuals with dementia. These care plans consider specific symptoms, needs, and preferences. They demonstrate a comprehensive understanding of the condition beyond generalizations. This approach helps shift the focus from stigma-laden assumptions to individualized, compassionate care.
  3. Staff education and training: Senior care software often includes educational resources about dementia and utilizes ICD-10 codes as a starting point. Staff members can access information about different types of dementia, symptoms, and effective communication strategies. A well-informed staff is more likely to provide empathetic and respectful care, which can help combat stigma at the ground level.
  4. Reporting and analytics: Long-term care software can generate reports and analytics based on ICD-10 codes. This data-driven approach helps administrators identify trends, allocate resources, and plan interventions. By highlighting the prevalence and needs of individuals with dementia, the software gives decision-makers the ability to prioritize anti-stigma initiatives.
  5. Collaborative care: Long-term care EHR software often connects multiple professionals, including physicians, nurses, therapists, and social workers. Using ICD-10 codes ensures consistent communication across these disciplines. This fosters better collaboration based on standardized codes to offer a holistic view of dementia and reduce the risk of perpetuating uninformed biases.
  6. User-friendly interfaces: State-of-the-art nursing home software presents ICD-10 codes and related information in user-friendly ways. Clear explanations and visual aids enhance the usability of the software, ensuring that all staff members are comfortable working with the codes and engaging in discussions about dementia.

Integrating ICD-10 codes into long-term care software results in accurate documentation, person-centered care, staff education, data-driven decision-making, and transparent communication. This comprehensive approach contributes to transforming the narrative around dementia from one of fear and misunderstanding to empathy and informed care.

For more on recent trends in long-term care, read our blog and subscribe to the LTC Heroes podcast