CASE STUDY - Valley Nursing Home patient with presenile dementia and depressive features. Select the appropriate code.

CASE STUDY - Valley Nursing Home patient with presenile dementia and depressive features. Select the appropriate code.

• A. F03.90
• B. F03.91
• C. F32.9
• D. F43.22

Answer: (A)

The key idea is coding dementia when there isn’t a separate mood disorder documented. Dementia codes start with F03.x, and F03.9x is used for unspecified dementia. If there’s no mention of behavioral disturbances, the correct specifier is the one without behavioral disturbance. The scenario notes presenile dementia and depressive features, but it doesn’t state a formal mood disorder diagnosis or behavioral disturbance. Therefore, the single best code is unspecified dementia without behavioral disturbance. The other codes don’t fit as neatly. F03.91 would be used only if there were a recorded behavioral disturbance accompanying the dementia. F32.9 would be used only for a diagnosed major depressive disorder, which isn’t stated here—“depressive features” isn’t the same as a depressive disorder. F43.22 would apply to an adjustment disorder with mixed anxiety and depressed mood, which isn’t described in this dementia case. If a mood disorder were diagnosed separately, you could code both conditions, but with the information given, the dementia code alone is most appropriate.

The key idea is coding dementia when there isn’t a separate mood disorder documented. Dementia codes start with F03.x, and F03.9x is used for unspecified dementia. If there’s no mention of behavioral disturbances, the correct specifier is the one without behavioral disturbance. The scenario notes presenile dementia and depressive features, but it doesn’t state a formal mood disorder diagnosis or behavioral disturbance. Therefore, the single best code is unspecified dementia without behavioral disturbance.

The other codes don’t fit as neatly. F03.91 would be used only if there were a recorded behavioral disturbance accompanying the dementia. F32.9 would be used only for a diagnosed major depressive disorder, which isn’t stated here—“depressive features” isn’t the same as a depressive disorder. F43.22 would apply to an adjustment disorder with mixed anxiety and depressed mood, which isn’t described in this dementia case. If a mood disorder were diagnosed separately, you could code both conditions, but with the information given, the dementia code alone is most appropriate.