ACS 0003 Supplementary codes for chronic conditions – Dementia

Created Aug 2019

Query

A patient is admitted with delirium secondary to urinary tract infection (UTI) and has a background of dementia. If the dementia does not meet ACS 0002 Additional diagnoses, can the supplementary code U79.1 Dementia (including in Alzheimer's disease) be assigned rather than a code from the range F00-F03 (or F1-.5)? Or does the Coding Rule Q2649 Confusion or delirium with dementia override this and we continue to assign the appropriate dementia code?

Response

The ACCD Coding Rule Q6249 Confusion or delirium with dementia was updated June 2019 as part of Eleventh Edition.  The Coding Rule now states: 
“where acute confusional state/delirium is specifically documented in a patient who also has dementia AND documentation states that the acute confusional state/delirium is due to a general medical condition, assign F05.8 Other delirium in addition to the general medical condition (other than dementia).”
Therefore, a dementia code from range F00-F03 is to be assigned in these cases.

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