What ICD-10 Code is for Delirium?

What Are ICD-10 Codes?

Back in 1898, doctors and other people involved in the 19th century healthcare field codified a list of diseases that were known at that time. That year is generally accepted as the beginning of ICD-1, with ICD standing for International Classification of Diseases. Currently, the most widely accepted list is ICD-10, meaning that it’s the 10th version of the original. ICD-11 has been  released, but a great many countries have not yet implemented the changes.  Current estimates state that ICD-11 won’t be completely in place until 2025, or even later, so for all intents and purposes, ICD-10 is still the current revision.

ICD-10 is a  list of diseases that are organized by code. Each disease is assigned a code, and if there are any subcategories of each disease, then each of the subcategories gets its own code. Usually, the codes of these subcategories are variants on the main code for the primary disease. Each code also comes with a detailed summary of the disease, its symptoms, options for treatment, information about client prognosis over both the short term and long term, and other relevant statistics.

The idea behind maintaining the list is to keep tabs on how diseases affect the population and how they spread. It’s a crucial component in any treatment strategy applicable to large swaths of the population. As with COVID-19, there are multiple strains that have arisen through mutation, and the treatment options for each strain differ from each other even if it’s only slightly. Additionally, whenever researchers create a new treatment for a certain disease, disseminating that information is central to the treatment of that disease. Having a codified list to which everyone can refer is immensely helpful in the treatment of any disease. 

It’s also important to track the side effects of treatments and medications. Comparing the side effects to the disease’s symptoms, and their severity, is useful in determining if a certain treatment is worthwhile or just “worse than the disease” itself.

Many diseases also affect each other in the people afflicted with them. In these cases, medical professionals need to know how the diseases relate to one another and how using one medication to treat one might interfere with the treatment of the other. Comorbid conditions are, by their nature, complex and difficult to treat, so having all the most pertinent information available is important.

Researchers and medical professionals in the field also need to know how many people experience those comorbid conditions. That way, they can track the effects of these conditions both by themselves and in conjunction with other conditions. Through analysis of these relationships between diseases, they can then devise new treatment strategies. Drug companies can use the data, as well, to create, test, and eventually distribute new medicines that doctors can use as part of their treatment regimens.

Also, American healthcare is replete with red tape, insurance bureaucracy, and waste. Companies can use ICD-10 codes to help streamline billing and payment information along with forecasting trends and upgrading claim systems.

ICD-10 Code F05.0: Delirium Due to Known Physiological Condition

There are 54 codes associated with delirium in ICD-10. Aside from F05.0 and its subcategories, the others all relate to delirium caused by outside stimuli, such as through the use of alcohol, inhalants, or psychotropic drugs along with others. Those codes also have subcategories of codes. Examples include delirium through the use of the illicit substances themselves and also the delirium caused by withdrawal.

As with many basic codes in ICD-10, the American health insurance system cannot bill under F05.0. Billing must occur under one of the subcategories, which are much more specific than the basic code. However, because delirium is associated with other conditions, such as dementia, subacute brain syndrome, or even epilepsy, the entire collection of F05 codes is sometimes classified as a sub-subcategory of other ICD-10 codes. 

For example, when it comes to Alzheimer’s disease, which is G30.9, delirium is a symptom of certain stages of the disease. Further, if someone experiences comorbid conditions that also cause delirium, then there might be further drilling down into other subcategories. This can create a veritable “family tree” of conditions that health insurance companies must correctly collate to ensure that people receive the correct treatment for each of their specific conditions.

Delirium Itself

Delirium is a mental state where thought processes are disrupted, cognitive abilities are reduced or nonexistent, and there is a complete lack of acute awareness of situation and surroundings. When it comes to the physiological causes of delirium, unless there is an outside stimulus, they’re usually associated with underlying conditions like dementia, imbalance of chemicals or elements in the body, or even severe fever related to another disease.

Depending on the situation, delirium can creep up on you over several hours or days, or it can happen suddenly. Interestingly, delirium manifests itself more during periods of darkness than of light. In fact, one certain kind of delirium is called sundowning, which is where a person might be aware and sharp at noon but begin showing signs of disassociation and confusion as soon as the sun sets.

The early signs include people becoming easily distracted, not responding to questions, and homing in on a single idea and discussing nothing but that in conversations. Lack of focus and withdrawal from interactions with others are also common in the early stages. As the condition worsens, people might ramble incoherently, forget who they are, and not be able to remember things that happened as little as a few minutes prior.

At all times when someone is experiencing delirium, mood changes, such as sudden anger juxtaposed with maudlin behavior a few minutes later, hallucinations, and a warped perception of time all show themselves. It’s uncommon, but some people with delirium also experience circadian problems in the same manner as blind people, switching day and night cycles.

There are three general categories of delirium. The first is hyperactive delirium, which is where the person becomes restless and has frequent, and often violent, mood swings. They’ll pace incessantly while babbling nonsense, and the aforementioned hallucinations are common.

The second type is hypoactive delirium. Basically, it’s the opposite of hyperactive delirium. People suddenly withdraw from contact into themselves. Their babbling is mostly to themselves rather than to others. They sometimes exhibit behaviors that mimic autism, such as rocking or making repetitive motions. They don’t generally sleep well, but they will be drowsy, sluggish, and often dazed.

The third type is mixed delirium. This is where the person vacillates from one of the two above versions of delirium to the other. Any of these three versions of delirium can occur with any physiological cause or outside stimulus.

When it comes to dementia and/or Alzheimer’s disease, specifically, the lines between the underlying condition and the symptom of delirium become blurred because the signs of both are so similar. The thing that’s different is that delirium itself doesn’t actually destroy brain cells. The underlying condition or outside stimulus is what does the destroying.

Sometimes, dementia and delirium are mistaken for one another because the symptoms are so similar. There are subtle differences, however, so it’s important for medical professionals to be both vigilant and careful when assessing someone experiencing symptoms. The person could have one of the conditions, both, or neither. 

Dementia is a chronic condition, and the person will experience symptoms over a long period of time. It’s an incurable condition, so the person never shows any improvement. Treatments are largely to delay the onset of worse symptoms or the exacerbation of existing symptoms. On the other hand, delirium appears quickly, usually in one or two days but sometimes over the course of only a few hours.

Delirium comes with sluggishness and/or agitation and restlessness. These symptoms are generally absent in someone with dementia unless the person is also experiencing delirium for one reason or another. The symptoms of delirium can also come and go throughout the day. Dementia symptoms are permanent.

When someone is experiencing delirium, the symptoms could be misleading when it comes to dementia. For this reason, medical professionals should wait until a period of delirium subsides before assessing someone for dementia.

Treating delirium begins with ensuring the client’s safety. When the person is unaware of the surroundings, particularly, those seeing to their care should keep them away from hazards. Also, the person should be kept away from mundane objects that could be hazardous, such as furniture with corners and edges, all sharp objects, or stairs. Second, an individual experiencing delirium needs to be on a regular cycle of sleeping and being awake. Resetting the person’s circadian rhythm is an important component in healing.

When treating delirium, if the cause is fever or some other medical condition, doctors must use strategies that incorporate the treatment of comorbid conditions. Keeping a tight schedule and reorienting the person with the process are both good ways to combat the onset of delirium. A good way to do that is to write the day of the week and the date in large letters on a board that is visible to the person. It’s also a good idea to reschedule blood draws and other care so that they don’t occur overnight if at all possible. That will reinforce the individual’s circadian rhythm.

Medication isn’t usually used to treat delirium itself. Rather, it’s used to treat the aforementioned comorbid conditions. These could include an antibiotic to counter a high fever associated with bacterial influenza or Alpha-2 agonists to offset the effects of agitation and restlessness. It should be borne in mind, however, that medications are only part of the overall strategy. In fact, nonmedicinal strategies are effective alone in 44% of cases of delirium.

Why Accuracy Is Important

Of course, being accurate is imperative when treating anyone for anything. We don’t want people being misdiagnosed and then treated incorrectly. That could prove catastrophic. Additionally, we don’t want people in need of care being turned down by their insurance companies because of faulty or missing paperwork. That’s where the ICD-10 codes come in. They allow companies to bill insurance companies accurately so that people can get the coverage for which they’ve already paid.

It’s just the right thing to do to make sure that people who have paid to have coverage should receive the care they need. 

How AutoNotes Can Help

AutoNotes is a fully encrypted AI program that complies fully with the Health Insurance Portability and Accountability Act of 1996. That encryption protects client information and keeps it confidential. All medical professionals, including doctors and therapists of various specialties and foci, can use AutoNotes to create thorough and detailed clinical notes. The program does all the work, so the medical professional doesn’t have to spend hours upon hours doing it.

Using an array of templates, the physician creates a profile through the program. The profile is based upon specific criteria and information relative to the client. The program is capable of creating customized profiles for all people. These profiles are easily modified if the client’s situation changes. When you update the information in the profile, AutoNotes will automatically change the relevant treatment plan strategies. It will do this for each change on each client’s profile.

The medical professional is saved from the drudgery of entering complex notes because AutoNotes will be able to create the right profile from just a few sentences spoken into the program. The profile will contain all relevant diagnoses and their accompanying treatment plans. Because a human touch is necessary for the highest accuracy, you get to review everything that AutoNotes creates. Once everything is shipshape, then you can export it to a .PDF and print it.

The benefits are obvious. Unburdened by tedious administrative work, medical professionals can concentrate more on their actual clients. That enables them to give better care to their clients while improving the accuracy of their recordkeeping.

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