The month of June is observed as Alzheimer’s & Brain Awareness Month – an opportunity to support people worldwide who struggle with Alzheimer’s disease and other forms of dementia. Alzheimer’s disease (AD) is regarded as one of the most common forms of dementia, which ranks as the sixth leading cause of death in the United States and the fifth leading cause of death among Americans age 65 and older. It is estimated that worldwide, 47 million people are living with Alzheimer’s and other dementias and these numbers are expected to grow to 76 million by 2030. So, to raise awareness of Alzheimer’s disease, The Alzheimer’s Association, asks people around the world to wear purple and use their brains to fight Alzheimer’s disease. The month-long campaign aims to generate awareness, highlight issues faced by Alzheimer’s patients and demonstrate how they can overcome these issues and live well with the condition. It’s also considered as a time to recognize the warriors who provide unconditional love and care to those who suffer from cognitive decline and degenerative brain diseases. Neurologists treating Alzheimer’s patients must use the correct diagnosis and procedural codes on their medical claims. Physicians can ensure accurate clinical documentation of this brain disorder with the support of medical billing outsourcing companies.

Alzheimer’s is an incurable disease that kills nerve cells and tissue in the brain, that is affecting an individual’s ability to remember, think and plan. Eventually those with the disease will lose their ability to communicate, recognize family and friends, and care for themselves. It’s a fact that everyone who has a brain is at risk to develop Alzheimer’s, the only leading cause of death that cannot be prevented, cured or even slowed.

Symptoms & Causes

The early signs of this disease may be forgetting recent events or conversations. As the disease progresses, Alzheimer’s patients will develop severe memory impairment and lose the ability to carry out everyday tasks.

The symptoms to look for include:

  • Memory loss (especially short-term)
  • Trouble making plans and solving problems
  • Confusion over times or places
  • Misplacing objects

AD patients also experience mood and personality changes. The steady deterioration of memory, function, and behavior takes its toll emotionally and physically on all those involved.

The exact causes of Alzheimer’s disease aren’t fully understood, but scientists believe that for most people it is caused by a combination of genetic, lifestyle and environmental factors that affect the brain over time. Problems with brain proteins disrupt the work of brain cells (neurons). Neurons, when damaged lose connections to each other and eventually die. The damage most often starts in the region of the brain that controls memory and this process begins years before the first symptoms. The loss of neurons spreads in a somewhat predictable pattern to other regions of the brains and towards the late stage of the disease, the brain has shrunk significantly.

Top risk factors associated with the condition include – age, gender, Down syndrome, family history and genetics, poor sleep patterns, mild cognitive impairment, past head trauma, lifestyle patterns, cardiovascular health and other social and cognitive engagement. Changing lifestyle habits would help alter your risk level to some extent.

Mayo clinic says that even though Alzheimer’s disease is not a preventable condition, evidences suggests that a number of lifestyle risk factors for Alzheimer’s can be modified to reduce the risk of cardiovascular disease – so that it may also lower your risk of developing Alzheimer’s disease and other disorders that cause dementia. Heart-healthy lifestyle choices that may reduce the risk of Alzheimer’s include the following:

  • Exercise regularly
  • Eat fresh produce, healthy oils and foods low in saturated fat
  • Follow treatment guidelines to manage high blood pressure, diabetes and high cholesterol
  • Quit smoking

Participate in social events, reading, dancing, playing board games, creating art, playing an instrument, and other activities that require mental and social engagement.

Diagnosis & Treatment

Self-reporting about symptoms as well as the information that a close family member or friend can provide about symptoms and their impact on daily life, is one of the key components of a diagnostic assessment. Even though there is no specific test that completely confirms the presence of this brain syndrome, certain laboratory and imaging tests – such as Electroencephalogram (EEG), Magnetic resonance imaging (MRI), Computerized tomography (CT), and Positron emission tomography (PET) – can rule out other potential causes or help the doctor better characterize the disease causing dementia symptoms. These standard diagnosis and screening tests allow physicians to identify the exact symptoms so that they can initiate early treatment without making any further complications.

However, another main concern regarding this disease is its treatment cost. The costs of health care and long-term care for individuals living with Alzheimer’s or other dementias are substantial.

According to The Alzheimer’s Association, in 2020, Alzheimer’s and other dementias will cost the nation $305 billion, including $206 billion in Medicare and Medicaid payments. Unless a treatment to slow, stop or prevent the disease is developed, in 2050, Alzheimer’s is projected to cost more than $1.1 trillion (in 2020 dollars). This dramatic rise includes more than four-fold increases both in government spending under Medicare and Medicaid and in out-of-pocket spending. This is mainly because,

  • People living with Alzheimer’s or other dementias have twice as many hospital stays per year as other older people.
  • Medicare beneficiaries with Alzheimer’s or other dementias are more likely than those without dementia to have other chronic conditions, such as heart disease, diabetes and kidney disease.
  • Older people living with Alzheimer’s or other dementias have more skilled nursing facility stays and home health care visits per year than other older people.
  • People living with Alzheimer’s or other dementias make up a large proportion of all elderly people who receive adult day services and nursing home care.

For AD patients, depending Medicare can help a little bit, because, Medicare offers coverage for medical and mental health conditions, which may cover ongoing hospital care, doctor visits, physical exam and several other tests. Neurologists or other specialists offering treatment for AD have to report the correct diagnostic and procedural codes on the claims to ensure due coverage. Providers need to focus on ensuring that the right ICD-10 codes are used for Neurology medical billing and coding purposes.

ICD-10 codes used for Alzheimer’s Disease (AD)

There are four ICD-10-CM codes for Alzheimer’s disease:

  • G30.0: Alzheimer’s disease with early onset
  • G30.1: Alzheimer’s disease with late onset
  • G30.8: Other Alzheimer’s disease
  • G30.9: Alzheimer’s disease, unspecified

Is It Alzheimer’s or Dementia?

Many people use the words Alzheimer’s and dementia indistinguishably, but dementia is a broad term describing certain symptoms, while Alzheimer’s is a disease. As the Alzheimer’s Association clarifies, “Alzheimer’s is a degenerative brain disease and the most common form of dementia, which is not a specific disease, but an overall term that describes a group of symptoms.”

Dementia with or without behavioral disturbances is coded separately from Alzheimer’s:

  • F02.80: Dementia in other diseases classified elsewhere without behavioral disturbance
  • F02.81: Dementia in other diseases classified elsewhere with behavioral disturbance

When Alzheimer’s sufferers experience agitation, aggression, and other behavioral disturbances, the level of care necessary to keep them safe increases, so be sure these manifestations are included in the provider documentation and code accordingly.

Additional problems commonly seen with Alzheimer’s include:

Delirium

  • F05: Delirium due to known physiological condition

Wandering

  • Z91.83: Wandering in diseases classified elsewhere)

Proper coding requires medical coders to know the difference. An experienced medical coding company can help physicians report diagnosis using the correct ICD-10 codes.

Join the Campaign against Alzheimer’s (AD) this June to take action to help end the Alzheimer’s epidemic and raise awareness of the disease.