G30 Alzheimer's vs Vascular dementia

kphilp@newcenturyhospice.com

I have a question regarding G30.- Alzheimer's disease. I understand including dementia with or without behavioral disturbance, but when vascular dementia is included then F02.8- would not be included correct? Otherwise you are stating two different types of dementia for the Alzheimer's either vascular or dementia. For the excludes 1 or excludes2 notes should be more specific either excludes 1 for both Vascular dementia F01.5- and for F02.- . Under F01 there are no excludes notes and there are excludes under F02. I think for less confusion for coders who are teaching it should be under both and more specific.

kphilp@newcenturyhospice.com

Thanks Susan

Question would use continue to use F02.8- along with F01.- due to the guidelines?

kphilp@newcenturyhospice.com

Thank you, I thought so, and that is what I have been doing. I was just reading too much into it.

Thanks again

Justine

A follow-up question...if the patient has Vascular Dementia as a late effect of a CVA, are you coding "Other sequelae of cerebral infarction" followed by the Vascular Dementia code? I just had a patient with this same scenario and that is how I coded it, however, the term "cognitive deficits" was also all over the patient's record, so I had to stop myself from coding the late effect of CVA with cognitive deficits. I often see these terms used interchangeably on the hospital record (grrr). I used the more specific diagnosis of Vascular Dementia, but I wonder what others are doing? Thanks!

Lauriesmulick@yahoo.com

I have gone back and fourth with this many times. I was using the other specified sequelae followed by the vascular dementia until recently. I have viewed a webinar and purchased a study guide for a coding certification exam (both within the last three weeks) and they both gave the example of CVA with vascular dementia and instructed to list cognitive deficits as a sequelae of cerebral vascular disease (CVA),I69.31 and the F01.5_ code. Prior to that, I was looking at it from the standpoint that the vascular dementia was the actual sequela.