Alzheimers/Vascular Dementia

KellyFeist@catholichealth.net

Patient has hx of ischemic stroke with right upper extremity weakness. Also has bilateral carotid artery stenosis. He is now diagnosed with Alzheimer's and vascular dementia.
Any ideas how to code this?

Would this be correct?
I65.23 Stenosis of bilateral carotid arteries
I69.331 Monoplegia following cerebral infarction
F01.50 Vas. dementia
G3.09 Alzheimers
f02.80 Dementia

Thanks in advance for any ideas!!

Justine

If the patient has a history of an infarct, you cannot code the Carotid Artery Stenosis in Home Health. You may code it if the patient has not had an infarct. In this case, however, you would want to code the late effect of the CVA and not the carotid artery stenosis. If the Alzheimer's is newly diagnosed, I would code that before the late effect of the CVA. Also, as long as the physician states the patient has Alzheimer's with Dementia and a late effect of CVA with Vascular Dementia, you are able to code both.

Justine

Darn, I meant to also say that before coding the Vascular Dementia you would first code I69.398 "Other sequelae of cerebral infarction" followed by the Vascular Dementia code.

cbrunk@totalhh.com

There is code for cognitive changes--I69.31 followed by F01.50

Priscilla Brunk RN, HCS-D
Corporate Coder
Cell: 772-284-1185
Fax: 954-962-2667