An 82-year-old woman has had Parkinson’s disease for several years and was recently diagnosed with dementia after exhibiting combative behavior and wandering off. The physician’s H&P describes the dementia as a manifestation of Parkinson’s. She is admitted to home health for management and teaching on new medications and the dementia disease process.
Code the scenario:
| Primary and Secondary Diagnoses | M1025 Additional diagnoses | ||
| M1021a: Parkinson’s disease | G20 | ||
| M1023b: Dementia in other diseases classified elsewhere with behavioral disturbance | F02.81 | ||
| M1023c: Wandering in diseases classified elsewhere | Z91.83 | ||
Rationale:
- The patient’s dementia with behavioral disturbance is a manifestation of her Parkinson’s disease.
- Sequence the Parkinson’s disease code (G20) first, followed by F02.81.
- Even though the dementia is the focus of care, the coding guidelines require the Parkinson’s disease to be coded first.
- Include additional code (Z91.83) to capture the patient’s wandering, in accordance with tabular instruction.