How to Correctly Code for Parkinson’s Disease using ICD-10 Codes

How to correctly code for

Parkinson’s Disease using ICD-10 Codes

Parkinson’s disease (PD) is a chronic and progressive disorder of the nervous system. The article highlights certain ICD-10 coding guidelines for PD.

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Parkinson’s disease (PD) is a chronic and progressive brain disorder that affects movement, causing loss of muscle control and balance. According to the Parkinson’s Foundation, about seven to ten million people worldwide suffer from this neurodegenerative disorder. Every year, about 60,000 Americans are diagnosed with Parkinson’s disease, and this estimate excludes the thousands of cases that go undetected. This disease develops gradually, in most cases, starting with a barely noticeable tremor in just one hand. Medical billing and coding for Parkinson disease (PD) is complex, and to meet the complicated documentation requirements, most neurology practices now depend on medical coding outsourcing.

What Causes PD? Parkinson’s disease is caused by a loss of nerve cells in a part of the brain called the “substantia nigra”. This leads to a reduction in a chemical called “dopamine” in the brain. Dopamine plays a major role in regulating the movement of the body. A reduction in the level of dopamine is responsible for many of symptoms of PD. The exact reason that causes the loss of nerve cells is unclear. However, most experts believe that a combination of genetic and environmental factors is responsible.

Early detection of symptoms increases the chances of recovery of this condition.

Hence, it is important for people to become aware about the warning signs of neurological disorder.

The prominent signs and symptoms of Parkinson’s disease may vary from one person to another. Initial signs may be mild and often go unnoticed. In most cases, symptoms begin on one side of the body and usually remain worse on that side, even after symptoms begin to affect both sides. Common signs and symptoms include –      

Involuntary shaking of particular parts of the body (tremor) Slow movements (bradykinesia) Rigid muscles Loss of automatic movements Impaired posture and balance Speech changes and writing changes

However, a person with PD can also experience a wide range of other physical and psychological symptoms such as – • • • •

Depression and anxiety Loss of sense of smell (anosmis) Problems sleeping (insomnia) Memory problems

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Diagnosis and Clinical Documentation of Parkinson’s Disease There is no specific test to diagnose Parkinson’s disease. Based on your previous medical history, a neurologist will review your individual signs and symptoms, and conduct a neurological and physical examination. In some cases, blood tests may be conducted to rule out other conditions that may be causing your symptoms.

Several diagnostic imaging tests such as MRI, ultrasound of the brain, SPECT and PET scans may also be conducted to diagnose this condition.

Accurately diagnosing the condition and submitting proper clinical documentation is important for promoting error-free billing practices. Relying on the services of a professional medical coding company can ensure this. Clinical documentation must also document the specific type of Parkinson’s disease. G20 is the ICD-10 CM code used to specify a diagnosis.

G20 - Parkinson's disease ICD-10 CM code G-20 is applicable to     

Hemiparkinsonism Idiopathic Parkinsonism or Parkinson's disease Paralysis agitans Parkinsonism or Parkinson's disease NOS Primary Parkinsonism or Parkinson's disease

Exclusion specific to G20: ‘Dementia with Parkinsonism’ is not included in the above set and has to be coded using G31.83. 

G21 - Secondary Parkinsonism

This excludes - G31.83 (dementia with Parkinsonism), G10 (Huntington's disease), G90.3 (Shy-Drager syndrome) and A52.19 (Syphilitic Parkinsonism). 

G21.0 - Malignant neuroleptic syndrome

(Use additional code for adverse effect, if applicable, to identify drug (T43.3X5, T43.4X5, T43.505, T43.595). This excludes - G21.11 - Neuroleptic induced Parkinsonism.  

G21.1 - Other drug-induced secondary Parkinsonism G21.11 - Neuroleptic induced Parkinsonism

(Use additional code for adverse effect, if applicable, to identify drug (T43.3X5, T43.4X5, T43.505, T43.595). This excludes - G21.0 - Malignant neuroleptic syndrome

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

G21.19 - Other drug induced secondary Parkinsonism, Other medicationinduced Parkinsonism

(Use additional code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)     

G21.2 - Secondary Parkinsonism due to other external agents (Code first (T51-T65) to identify external agent) G21.3 - Post encephalitic Parkinsonism G21.4 - Vascular Parkinsonism G21.8 - Other secondary Parkinsonism G21.9 - Secondary Parkinsonism, unspecified

As coding for Parkinson’s disease involves detailed processes, relying on neurology medical billing and coding services provided by a reputable outsourcing company can help providers avoid claim denials and ensure optimal reimbursement.

www.outsourcestrategies.com

1-800-670-2809