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Classifying the Manifestations of Alzheimers Disease in DSMIVTR

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... specifier: with behavioral disturbance) DAT, with late onset ... (uncoded specifier: with behavioral disturbance) Code Alzheimer's disease (331.0) on Axis III ... – PowerPoint PPT presentation

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Title: Classifying the Manifestations of Alzheimers Disease in DSMIVTR


1
Classifying the Manifestations of Alzheimers
Disease in DSM-IV-TR
  • Eric D. Caine, M.D.
  • John Romano Professor and Chair
  • Departmet of Psychiatry
  • University of Rochester Medical Center
  • Rochester, N.Y.

2
The Expression of Diseases
  • Fundamental pathobiological processes
  • molecular
  • biochemical/physiological
  • Primary manifestations
  • histopathological
  • Secondary manifestations
  • clinical signs and symptoms

3
Huntingtons disease (chorea)
  • CAG repeats
  • Basal ganglia histopathology/degeneration
  • Cognitive, psychiatric, motor signs and symptoms

4
Alzheimers disease
  • Multiple unknown molecular mechanisms
  • Characteristic histopathology
  • Cognitive and psychiatric signs and symptoms

5
Past DSM-IV Classification of Dementia of the
Alzheimers Type
  • DAT, with early onset
  • 290.10 uncomplicated
  • 290.11 with delirium
  • 290.12 with delusions
  • 290.13 with depressed mood
  • (uncoded specifier with behavioral disturbance)
  • DAT, with late onset
  • 290.0 uncomplicated
  • 290.3 with delirium
  • 290.20 with delusions
  • 290.21 with depressed mood
  • (uncoded specifier with behavioral disturbance)
  • Code Alzheimers disease (331.0) on Axis III

6
DSM-IV-TR Coding of Dementia due to Alzheimers
Disease
  • Dementia due to Alzheimers disease
  • 294.10 without behavioral disturbance
  • 294.11 with behavioral disturbance
  • Code Alzheimers disease (331.0) on Axis III

7
DSM-IV Mental Disorders due to Alzheimers Disease
  • Psychotic Disorder due to 293.8
  • Mood Disorder due to 293.83
  • Anxiety Disorder due to 293.89
  • Personality Change due to 310.1
  • Sleep Disorder due to 780.5
  • Code Alzheimers disease (331.0) on Axis III

8
Proposed ICD-10-CM Coding of Dementia due to
Alzheimers Disease
  • Dementia due to AD, with early onset (G30.0x)
  • G30.00 without behavioral disturbance
  • G30.01 with behavioral disturbance
  • G30.00 unspecified
  • Dementia due to AD, with late onset (G30.1x)
  • G30.10 without behavioral disturbance
  • G30.11 with behavioral disturbance
  • G30.10 unspecified
  • (G codes ICD-10-CM Diseases of the Nervous
    System)
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