A US based medical billing and coding company with extensive experience in the field, Outsource Strategies International (OSI) provides revenue cycle management solutions for all medical specialties.

In today’s podcast, Natalie Tornese, one of our senior solutions managers, discusses the symptoms of Alzheimer’s disease (AD) and treatment options for the condition.

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Hello everyone and welcome to our podcast series. My name is Natalie Tornese. I am a Senior Solutions Manager at Outsource Strategies International (OSI). Wanted to take some time to talk about Alzheimer’s disease (AD).Alzheimer’s disease (AD) ranks as the sixth leading cause of death in the United States. It is an irreversible, progressive brain disorder that causes the brain cells to degenerate. The condition impairs mental functioning and causes a continuous decline in memory, thinking, behavior and social skills, and disrupts a person’s ability to function independently. Forgetting recent events or conversations can be the early signs and symptoms of the disease. However, as the disease progresses, a person with Alzheimer's disease will develop severe memory impairment and lose the ability to carry out everyday tasks. In most cases, patient symptoms first appear in their mid-60s. The condition impacts women more severely than men. Medications may temporarily improve symptoms or slow the rate of decline, but there is no specific treatment that will completely cure Alzheimer’s disease.

According to the Centers for Disease Control and Prevention (CDC), more than 5.8 million Americans live with Alzheimer’s in the United States now and this number is expected to grow to 14 million by the end of 2060.  The symptoms to look for include memory loss (especially short-term), trouble making plans and solving problems, confusion over times or places, and of course misplacing objects. Patients can also experience some mood and personality changes that can devolve into someone being confused, suspicious, or even depressed.

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

  • G30 – 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

    Under category G30, coders must assign the following additional codes to signify –

    • F05 – Delirium, if applicable
    • F02.81 – Dementia with behavioral disturbance
    • F02.80 – Dementia without behavioral disturbance
The exact cause of Alzheimer’s disease is not fully known, but they feel it’s caused by a combination of genetic, lifestyle and environmental factors that affect the brain over time. Problems with brain proteins disrupt the work of the brain – the neurons and the 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. The loss of neurons spreads to other regions of the brain and towards the late stage of the disease can just destroy more of it. Top risk factors associated with the condition include – age, gender, Down’s syndrome, family history and genetics, poor sleep patterns, mild cognitive impairment, past head trauma, lifestyle patterns, cardiovascular health, and other social and cognitive engagement.
There is no specific test that can completely confirm the presence of Alzheimer’s. But, physicians may conduct like a combination of cognitive, physical and neurological tests/exams to establish the presence of it. One of the key components of diagnostic assessment is self-reporting of symptoms as well as the information of a close family member or friend that may be able to reveal something about the symptoms and the patient’s direct impact on the quality of life. In addition, neurologists may recommend performing several other brain imaging tests like – EEGs, MRIs, CAT scans, and PET scans to confirm whether the patient has the condition. These standard diagnostic and screening tests will allow physicians to identify the exact symptoms so that they can initiate early treatment without making any further complications.
Medicare does offer coverage for medical and mental health conditions. This may cover ongoing hospital care, doctor visits, physical exams and several other tests. Neurologists and other specialists that offer treatment for Alzheimer’s must report the correct diagnostic and procedural codes on the claims to ensure due coverage.
I will include a transcript with these codes along with this podcast. I hope this helps. Always remember that documentation and a thorough knowledge of payer regulations and guidelines is critical to ensure accurate reimbursement for the procedures performed.
Thank you for listening.