Delirium Due to a General Medical Condition

A. Disturbance of consciousness  with reduced ability to focus, sustain, or shift attention. 

B. A change in cognition (such as memory deficit, disorientation, language disturbance) or the development of a perceptual disturbance that is not better accounted for by a preexisting, established, or evolving dementia.

C. The disturbance develops over a short period of time (usually hours to days) and tends to fluctuate during the course of the day. 

D. There is evidence from the history, physical examination, or laboratory findings that the disturbance is caused by the direct physiological consequences of a general medical condition.

Coding note: If delirium is superimposed on a preexisting Dementia of the Alzheimer's Type or Vascular Dementia, indicate the delirium by coding the appropriate subtype of the dementia,

e.g., 290.3 Dementia of the Alzheimer's Type, With Late Onset, With Delirium. 

note: Include the name of the general medical condition on Axis I,

e.g., 293.0 Delirium Due to Hepatic Encephalopathy; also code the general medical condition on Axis III.

Substance Withdrawal Delirium

Substance Intoxication Delirium

Delirium NOS

(if you have insiffiencet evidence to establish an etiology)

Dementia of the Alzheimer's Type 

The development of multiple cognitive deficits manifested by both 

  memory impairment 

and

1 (or more) of the following :  

  (a) aphasia (language disturbance) 

  (b) apraxia (impaired ability to carry out motor activities despite intact motor function) 
 

(c) agnosia (failure to recognize or identify objects despite intact sensory function) 

(d) disturbance in executive functioning (i.e., planning, organizing, sequencing, abstracting)

E. The deficits do not occur exclusively during the course of a delirium. 

F. The disturbance is not better accounted for by another Axis I disorder

Code based on presence or absence of a clinically significant behavioral disturbance:

294.10 Without Behavioral Disturbance

 

294.11 With Behavioral Disturbance

(e.g., wandering, agitation)

Specify subtype:

With Early Onset: if onset is at age 65 years or below 

With Late Onset: if onset is after age 65 years 

 

 

Coding note: Also code 331.0 Alzheimer's disease on Axis III.

Indicate other prominent clinical features related to the Alzheimer's disease on Axis I

(e.g., 293.83 Mood Disorder Due to Alzheimer's Disease, With Depressive Features,

and 310.1 Personality Change Due to Alzheimer's Disease, Aggressive Type).

indicate:

with delirum (if superimposed

with delusions

with depressed mood

uncomplicated

Vascular Dementia

same criteria as alhiemer type except instead of gradual onsetwith no other neuroloical cause

this has

Focal neurological signs and symptoms

(e.g., exaggeration of deep tendon reflexes, extensor plantar response, pseudobulbar palsy, gait abnormalities, weakness of an extremity)

or laboratory evidence indicative of cerebrovascular disease

(e.g., multiple infarctions involving cortex and underlying white matter) that are judged to be etiologically related to the disturbance.

Dementia Due to Other General Medical Conditions

(same criteria but different causes)

(also code on Axis III)

94.9 Dementia Due to HIV Disease

294.1 Dementia Due to Head Trauma

294.1 Dementia Due to Parkinson's Disease

294.1 Dementia Due to Huntington's Disease 

290.10 Dementia Due to Pick's Disease

290.10 Dementia Due to Creutzfeldt-Jakob Disease 

294.1 Dementia Due to...[Indicate the General Medical Condition not listed above]

For example, normal-pressure hydrocephalus, hypothyroidism, brain tumor, vitamin B deficiency, intracranial radiation

Substance-Induced Persisting Dementia

(same criteria but)

The deficits do not occur exclusively during the course of a delirium and persist beyond the usual duration of Substance Intoxication or Withdrawal. 

D. There is evidence from the history, physical examination, or laboratory findings that the deficits are etiologically related to the persisting effects of substance use (e.g., a drug of abuse, a medication). 

Code [Specific Substance]-Induced Persisting Dementia:  

(291.2 Alcohol; 292.82 Inhalant; 292.82 Sedative, Hypnotic, or Anxiolytic; 292.82 Other [or Unknown] Substance)

Dementia NOS

doesn;t meet other criteria or not enough info to dx