Understanding Dementia with Agitation: Find information on agitated dementia, including clinical documentation, medical coding, and healthcare resources. Learn about diagnosing and managing dementia with behavioral disturbance, along with best practices for patient care. This resource offers guidance for healthcare professionals on proper terminology and coding for dementia with agitation.
Also known as
Dementia with behavioral disturbance
Dementia including Alzheimer's disease with behavioral disturbance
Vascular and unspecified dementia
Covers various dementias including vascular and those not specified elsewhere.
Other degenerative diseases of nervous system
Includes other degenerative conditions potentially related to dementia symptoms.
Unspecified organic mental disorder
Use when a more specific dementia diagnosis isn't available.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the dementia diagnosis Alzheimer's disease?
Yes
Is agitation present?
No
Is the dementia vascular?
When to use each related code
| Description |
|---|
| Dementia with agitation and disruptive behaviors. |
| General term for decline in mental ability severe enough to interfere with daily life. |
| Neurocognitive disorder with behavioral disturbances, not due to dementia. |
Coding dementia without specifying the type (e.g., Alzheimer's, vascular) can lead to inaccurate reimbursement and quality reporting.
Insufficient documentation of agitation severity may impact medical necessity reviews for medications or behavioral interventions.
Failing to code coexisting conditions (e.g., depression, delirium) can affect risk adjustment and resource allocation.
Q: What are the best evidence-based non-pharmacological interventions for managing agitation in dementia patients in a long-term care setting?
A: Non-pharmacological interventions are often the first line of treatment for agitation in dementia patients residing in long-term care. These interventions aim to address underlying unmet needs and triggers. Evidence-based approaches include personalized activities tailored to the patient's remaining abilities and interests, such as music therapy, reminiscence therapy, or sensory stimulation. Creating a calm and predictable environment is crucial, minimizing overstimulation and maintaining consistent routines. Furthermore, caregiver training in communication techniques like validation therapy and positive reinforcement can significantly reduce agitation. Explore how structured behavioral interventions, like the Tailored Activity Program, can improve quality of life for these patients. Consider implementing regular assessments for pain and discomfort, as untreated physical symptoms can exacerbate agitation.
Q: How can I differentiate between delirium and agitated dementia in a patient presenting with sudden behavioral changes and confusion?
A: Differentiating between delirium and agitated dementia can be challenging, as both present with behavioral changes and confusion. Delirium typically has a rapid onset, fluctuating course, and is often associated with an underlying medical condition like an infection or medication side effect. Assess for changes in attention, awareness, and level of consciousness, which are hallmarks of delirium. Agitated dementia, on the other hand, usually has a more gradual onset and a progressive course. While both conditions may involve agitation, the underlying cause differs. A thorough medical evaluation, including cognitive testing, laboratory workup, and review of medications, is crucial for accurate diagnosis. Consider implementing the Confusion Assessment Method (CAM) to aid in identifying delirium. Learn more about the diagnostic criteria for dementia to further differentiate these conditions.
Patient presents with dementia with agitation, also known as agitated dementia or dementia with behavioral disturbance. The patient exhibits a decline in cognitive function, impacting memory, reasoning, and judgment, accompanied by significant behavioral disturbances including restlessness, pacing, verbal outbursts, and physical aggression. These symptoms are not solely attributable to delirium or another mental disorder. Assessment includes a comprehensive review of medical history, cognitive testing such as the Mini-Mental State Examination (MMSE) or Montreal Cognitive Assessment (MoCA), and evaluation of behavioral symptoms using scales like the Cohen-Mansfield Agitation Inventory (CMAI). Differential diagnosis considered delirium, psychiatric disorders, and medication side effects. Current medications were reviewed for potential exacerbating factors. Plan includes non-pharmacological interventions such as environmental modifications, behavioral therapy, and caregiver education. Pharmacological management may be considered, including antipsychotics, mood stabilizers, or cholinesterase inhibitors, with careful consideration of potential risks and benefits. Ongoing monitoring of cognitive function, behavioral symptoms, and medication effectiveness will be essential. Patient and family counseling regarding disease progression, management strategies, and available support services is crucial. ICD-10 code F02.81 (Dementia in other diseases classified elsewhere with behavioral disturbance) is considered for this encounter, along with relevant CPT codes for evaluation and management services.