Dementia

Dementia – Definitions & ICD 11 Codes

Definition of Dementia: Dementia is an acquired brain syndrome characterized by a decline from a previous level of cognitive functioning. Memory impairment is present in most forms of dementia, but cognitive impairment is not restricted to memory (i.e., there is impairment in other areas such as executive functions, attention, language, social cognition and judgment, psychomotor speed, visuoperceptual or visuospatial abilities). The cognitive impairment is not attributable to normal aging and significantly interferes with independence in the person’s performance of activities of daily living. The symptoms are not better accounted for by disturbance of consciousness, altered mental status, Delirium, Substance Intoxication, Substance Withdrawal, or another Mental, Behavioural, or Neurodevelopmental Disorder (e.g., Schizophrenia or Other Primary Psychotic Disorder, a Depressive Disorder). Based on available evidence, the cognitive impairment is attributed or assumed to be attributable to a neurological or medical condition that affects the brain, trauma, nutritional deficiency, chronic use of specific substances or medications, or exposure to heavy metals or other toxins.

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

Inclusions:

  • Dementia NOS

Exclusions:

Dementia due to Alzheimer disease

Definition of Dementia due to Alzheimer disease: Dementia due to Alzheimer disease is the most common form of dementia. Onset is insidious with memory impairment typically reported as the initial presenting complaint. The characteristic course is a slow but steady decline from a previous level of cognitive functioning with impairment in additional cognitive domains (such as executive functions, attention, language, social cognition and judgment, psychomotor speed, visuoperceptual or visuospatial abilities) emerging with disease progression. Dementia due to Alzheimer disease may be accompanied by mental and behavioural symptoms such as depressed mood and apathy in the initial stages of the disease and may be accompanied by psychotic symptoms, irritability, aggression, confusion, abnormalities of gait and mobility, and seizures at later stages. Positive genetic testing, family history and gradual cognitive decline are suggestive of Dementia due to Alzheimer disease.

ICD 11 Code For Dementia due to Alzheimer disease

  6D80  Dementia due to Alzheimer disease

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.

6D80.0 Dementia due to Alzheimer disease with early onset

Definition of Dementia due to Alzheimer disease with early onset: Dementia due to Alzheimer disease in which symptoms emerge before the age of 65 years. It is relatively rare, representing less than 5% of all cases, and may be genetically determined (autosomal dominant Alzheimer disease). Clinical presentation may be similar to cases with later onset, but progression of cognitive deficits may be more rapid.

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

6D80.1 Dementia due to Alzheimer disease with late onset

Definition of Dementia due to Alzheimer disease with late onset: Dementia due to Alzheimer disease that develops at the age of 65 years or above. This is the most common pattern, representing more than 95% of all cases.

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

6D80.2 Alzheimer disease dementia mixed type with cerebrovascular disease

Definition of Alzheimer disease dementia mixed type with cerebrovascular disease: Dementia due to Alzheimer disease and concomitant cerebrovascular disease.

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

6D80.3 Alzheimer disease dementia mixed type with other nonvascular aetiologies

Definition of Alzheimer disease dementia mixed type with other nonvascular aetiologies: Dementia due to Alzheimer disease with other concomitant pathology, not including cerebrovascular disease.

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

6D80.Z Dementia due to Alzheimer disease onset unknown or unspecified

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.

Dementia due to cerebrovascular disease

Definition of Dementia due to cerebrovascular disease: Dementia due to brain parenchyma injury resulting from cerebrovascular disease (ischemic or haemorrhagic). The onset of the cognitive deficits is temporally related to one or more vascular events. Cognitive decline is typically most prominent in speed of information processing, complex attention, and frontal-executive functioning. There is evidence of the presence of cerebrovascular disease considered to be sufficient to account for the neurocognitive deficits from history, physical examination and neuroimaging.

ICD 11 Code For Dementia due to cerebrovascular disease

  6D81  Dementia due to cerebrovascular disease

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.

Exclusions:

  • Alzheimer disease dementia, mixed type, with cerebrovascular disease (6D80.2)

Dementia due to Lewy body disease

Definition of Dementia due to Lewy body disease: Dementia preceding or occurring within one year after the onset of motor parkinsonian signs in the setting of Lewy body disease. Characterized by presence of Lewy bodies, which are intraneuronal inclusions containing α-synuclein and ubiquitin in the brain stem, limbic area, forebrain, and neocortex. Onset is insidious with attentional and executive functioning deficits often present. These cognitive deficits are often accompanied by visual hallucinations and symptoms of REM sleep behaviour disorder. Hallucinations in other sensory modalities, depressive symptoms, and delusions may also be present. The symptom presentation usually varies significantly over the course of days necessitating longitudinal assessment and differentiation from delirium. Spontaneous onset of Parkinsonism within approximately 1 year of the onset of cognitive symptoms is common.

ICD 11 Code For Dementia due to Lewy body disease

  6D82  Dementia due to Lewy body disease

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

Frontotemporal dementia

Definition of Frontotemporal dementia: Frontotemporal dementia (FTD) is a group of primary neurodegenerative disorders primarily affecting the frontal and temporal lobes. Onset is typically insidious with a gradual and worsening course. Several syndromic variants (some with an identified genetic basis or familiality) are described that include presentations with predominantly marked personality and behavioral changes (such as executive dysfunction, apathy, deterioration of social cognition, repetitive behaviours, and dietary changes),predominantly language deficits (that include semantic, agrammatic/nonfluent, and logopenic forms), predominantly movement-related deficits (progressive supranuclear palsy, corticobasal degeneration, multiple systems atrophy, or amyotrophic lateral sclerosis), or a combination of these deficits. Memory function, often remains relatively intact, particularly during the early stages of the disorder.

ICD 11 Code For Frontotemporal dementia

  6D83  Frontotemporal dementia

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

Dementia due to psychoactive substances including medications

Definition of Dementia due to psychoactive substances including medications: Dementia due to psychoactive substances including medications includes forms of dementia that are judged to be a direct consequence of substance use and that persist beyond the usual duration of action or withdrawal syndrome associated with the substance. The amount and duration of substance use must be sufficient to produce the cognitive impairment. The cognitive impairment is not better accounted for by a disorder that is not induced by substances such as a dementia due to another medical condition.

ICD 11 Code For Dementia due to psychoactive substances including medications

  6D84  Dementia due to psychoactive substances including medications

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

Exclusions:

  • Dementia due to exposure to heavy metals and other toxins (6D85.2)

6D84.0 Dementia due to use of alcohol

Definition of Dementia due to use of alcohol: Dementia due to use of alcohol is characterised by the development of persistent cognitive impairments (e.g., memory problems, language impairment, and an inability to perform complex motor tasks) that meet the definitional requirements of Dementia that are judged to be a direct consequence of alcohol use and that persist beyond the usual duration of alcohol intoxication or acute withdrawal. The intensity and duration of alcohol use must have been sufficient to produce the cognitive impairment. The cognitive impairment is not better accounted for by a disorder or disease that is not induced by alcohol such as a dementia due to another disorder or disease classified elsewhere.

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply. 
  • This category should not be used to describe cognitive changes due to thiamine deficiency associated with chronic alcohol use.

Inclusions:

  • Alcohol-induced dementia

Exclusions:

6D84.1 Dementia due to use of sedatives hypnotics or anxiolytics

Definition of Dementia due to use of sedatives hypnotics or anxiolytics: Dementia due to use of sedatives, hypnotics or anxiolytics is characterised by the development of persistent cognitive impairments (e.g., memory problems, language impairment, and an inability to perform complex motor tasks) that meet the definitional requirements of Dementia that are judged to be a direct consequence of sedative, hypnotic, or anxiolytic use and that persist beyond the usual duration of action or withdrawal syndrome associated with the substance. The amount and duration of sedative, hypnotic, or anxiolytic use must be sufficient to produce the cognitive impairment. The cognitive impairment is not better accounted for by a disorder that is not induced by sedatives, hypnotics, or anxiolytics such as a dementia due to another medical condition.

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

Inclusions:

  • Late-onset psychoactive substance-induced psychotic disorder

6D84.2 Dementia due to use of volatile inhalants

Definition of Dementia due to use of volatile inhalants: Dementia due to use of volatile inhalants is characterised by the development of persistent cognitive impairments (e.g., memory problems, language impairment, and an inability to perform complex motor tasks) that meet the definitional requirements of Dementia that are judged to be a direct consequence of inhalant use or exposure and that persist beyond the usual duration of action or withdrawal syndrome associated with the substance. The amount and duration of inhalant use or exposure must be sufficient to be capable of producing the cognitive impairment. The cognitive impairment is not better accounted for by a disorder that is not induced by volatile inhalants such as a dementia due to another medical condition.

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

6D84.Y Dementia due to other specified psychoactive substance

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

Dementia due to diseases classified elsewhere

ICD 11 Code For Dementia due to diseases classified elsewhere

  6D85  Dementia due to diseases classified elsewhere

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

6D85.0 Dementia due to Parkinson disease

Definition of Dementia due to Parkinson disease: Dementia due to Parkinson disease develops among individuals with idiopathic Parkinson disease and is characterized by impairment in attention, memory, executive and visuo-spatial functions. Behavioral and psychiatric symptoms such as changes in affect, apathy and hallucinations may also be present. Onset is insidious and the course is one of gradual worsening of symptoms.

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

6D85.1 Dementia due to Huntington disease

Definition of Dementia due to Huntington disease: Dementia due to Huntington disease occurs as part of a widespread degeneration of the brain due to a trinucleotide repeat expansion in the HTT gene, which is transmitted through autosomal dominance. Onset of symptoms is insidious typically in the third and fourth decade of life with gradual and slow progression. Initial symptoms typically include impairments in executive functions with relative sparing of memory, prior to the onset of motor deficits (bradykinesia and chorea) characteristic of Huntington disease.

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

Inclusions:

  • Dementia in Huntington chorea

6D85.2 Dementia due to exposure to heavy metals and other toxins

Definition of Dementia due to exposure to heavy metals and other toxins: Dementia due to exposure to heavy metals and other toxins caused by toxic exposure to specific heavy metals such as aluminium from dialysis water, lead, mercury or manganese. The characteristic cognitive impairments in Dementia due to exposure to heavy metals and other toxins depend on the specific heavy metal or toxin that the individual has been exposed to but can affect any cognitive domain. Onset of symptoms is related to exposure and progression can be rapid especially with acute exposure. In many cases, symptoms are reversible when exposure is identified and ceases. Investigations such as brain imaging or neurophysiological testing may be abnormal. Lead poisoning is associated with abnormalities on brain imaging including widespread calcification and increased signal on MRI T2-weighted images of periventricular white matter, basal ganglia hypothalamus and pons. Dementia due to aluminium toxicity may demonstrate characteristic paroxysmal high-voltage delta EEG changes. Examination may make evident other features such as peripheral neuropathy in the case of lead, arsenic, or mercury.

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

Exclusions:

  • Dementia due to psychoactive substances including medications (6D84)

6D85.3 Dementia due to human immunodeficiency virus

Definition of Dementia due to human immunodeficiency virus: Dementia due to human immunodeficiency virus develops during the course of confirmed HIV disease, in the absence of a concurrent illness or condition other than HIV infection that could explain the clinical features. Although a variety of patterns of cognitive deficit are possible depending on where the HIV pathogenic processes have occurred, typically deficits follow a subcortical pattern with impairments in executive function, processing speed, attention, and learning new information. The course of Dementia due to human immunodeficiency virus varies including resolution of symptoms, gradual decline in functioning, improvement, or fluctuation in symptoms. Rapid decline in cognitive functioning is rare with the advent of antiretroviral medications.

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

6D85.4 Dementia due to multiple sclerosis

Definition of Dementia due to multiple sclerosis: Dementia due to multiple sclerosis is a neurodegenerative disease due to the cerebral effects of multiple sclerosis, a demyelinating disease. Onset of symptoms is insidious and not secondary to the functional impairment attributable to the primary disease (i.e., multiple sclerosis). Cognitive impairments vary according to the location of demyelination but typically include deficits in processing speed, memory, attention, and aspects of executive functioning.

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

6D85.5 Dementia due to prion disease

Definition of Dementia due to prion disease: Dementia due to prion disease is a primary neurodegenerative disease caused by a group of spongiform encephalopathies resulting from abnormal prion protein accumulation in the brain. These can be sporadic, genetic (caused by mutations in the prion-protein gene), or transmissible (acquired from an infected individual). Onset is insidious and there is a rapid progression of symptoms and impairment characterised by cognitive deficits, ataxia, and motor symptoms (myoclonus, chorea, or dystonia). Diagnosis is typically made on the basis of brain imaging studies, presence of characteristic proteins in spinal fluid, EEG, or genetic testing.

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

6D85.6 Dementia due to normal pressure hydrocephalus

Definition of Dementia due to normal pressure hydrocephalus: Dementia due to normal pressure hydrocephalus results from excess accumulation of cerebrospinal fluid in the brain as a result of idiopathic, non-obstructive causes but can also be secondary to haemorrhage, infection or inflammation. Progression is gradual but intervention (e.g., shunt) may result in improvement of symptoms, especially if administered earlier in the course of the condition. Typically, cognitive impairments include reduced processing speed and deficits in executive functioning and attention. These symptoms are also typically accompanied by gait abnormalities and urinary incontinence. Brain imaging to reveal ventricular volume and characterize brain displacement is often necessary to confirm the diagnosis.

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

6D85.7 Dementia due to injury to the head

Definition of Dementia due to injury to the head: Dementia due to injury to the head is caused by damage inflicted on the tissues of the brain as the direct or indirect result of an external force. Trauma to the brain is known to have resulted in loss of consciousness, amnesia, disorientation and confusion, or neurological signs. The symptoms characteristic of Dementia due to injury to the head must arise immediately following the trauma or after the individual gains consciousness and must persist beyond the acute post-injury period. Cognitive deficits vary depending on the specific brain areas affected and the severity of the injury but can include impairments in attention, memory, executive functioning, personality, processing speed, social cognition, and language abilities.

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

6D85.8 Dementia due to pellagra

Definition of Dementia due to pellagra: Dementia due to pellagra is caused by persistent lack of vitamin B3 (niacin) or tryptophan either in the diet or due to poor absorption in the gastrointestinal tract due to disease (e.g., Crohn disease) or due to the effects of some medications (e.g., isoniazid). Core signs of pellagra include dermatological changes (sensitivity to sunlight, lesions, alopecia, and oedema) and diarrhoea. With prolonged nutritional deficiency cognitive symptoms that include aggressivity, motor disturbances (ataxia and restlessness), confusion, and weakness are observed. Treatment with nutritional supplementation (e.g., niacin) typically results in reversal of symptoms.

Coding Note:

  • Code also the causing condition

6D85.9 Dementia due to Down syndrome

Definition of Dementia due to Down syndrome: Dementia due to Down syndrome is a neurodegenerative disorder related to the impact of abnormal increased production and accumulation of amyloid precursor protein (APP) leading to formation of beta-amyloid plaques and tau tangles. APP gene expression is increased due to its location on chromosome 21, which is abnormally triplicated in Down syndrome. Cognitive deficits and neuropathological features are similar to those observed in Alzheimer disease. Onset is typically after the fourth decade of life with a gradual decline in functioning, and may impact 50% or more of individuals with Down syndrome.

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

6D85.Y Dementia due to other specified diseases classified elsewhere

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

Behavioural or psychological disturbances in dementia

Definition of Behavioural or psychological disturbances in dementia: In addition to the cognitive disturbances characteristic of dementia, the current clinical picture includes clinically significant behavioural or psychological disturbances.

ICD 11 Code For Behavioural or psychological disturbances in dementia

  6D86  Behavioural or psychological disturbances in dementia

Coding Note:

  • These categories should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of behavioural or psychological disturbance in dementia.
  • Code all that apply.

Exclusions:

6D86.0 Psychotic symptoms in dementia

Definition of Psychotic symptoms in dementia: In addition to the cognitive disturbances characteristic of dementia, the current clinical picture includes clinically significant delusions or hallucinations.

Exclusions:

6D86.1 Mood symptoms in dementia

Definition of Mood symptoms in dementia: In addition to the cognitive disturbances characteristic of dementia, the current clinical picture includes clinically significant mood symptoms such as depressed mood, elevated mood, or irritable mood.

Exclusions:

  • Mood disorders
  • Secondary mood syndrome (6E62)

6D86.2 Anxiety symptoms in dementia

Definition of Anxiety symptoms in dementia: In addition to the cognitive disturbances characteristic of dementia, the current clinical picture includes clinically significant symptoms of anxiety or worry.

Exclusions:

6D86.3 Apathy in dementia

Definition of Apathy in dementia: In addition to the cognitive disturbances characteristic of dementia, the current clinical picture includes clinically significant indifference or lack of interest.

Exclusions:

  • Mood disorders
  • Secondary mood syndrome (6E62)

6D86.4 Agitation or aggression in dementia

Definition of Agitation or aggression in dementia: In addition to the cognitive disturbances characteristic of dementia, the current clinical picture includes: 1) clinically significant excessive psychomotor activity accompanied by increased tension; or 2) hostile or violent behaviour.

6D86.5 Disinhibition in dementia

Definition of Disinhibition in dementia: In addition to the cognitive disturbances characteristic of dementia, the current clinical picture includes clinically significant lack of restraint manifested in disregard for social conventions, impulsivity, and poor risk assessment.

6D86.6 Wandering in dementia

Definition of Wandering in dementia: In addition to the cognitive disturbances characteristic of dementia, the current clinical picture includes clinically significant wandering that put the person at risk of harm.

6D86.Y Other specified behavioural or psychological disturbances in dementia

Coding Note:

  • These categories should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of behavioural or psychological disturbance in dementia.
  • Code all that apply.

6D86.Z Behavioural or psychological disturbances in dementia unspecified

Coding Note:

  • These categories should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of behavioural or psychological disturbance in dementia.
  • Code all that apply.

Dementia other specified cause

ICD 11 Code For Dementia other specified cause

  6D8Y  Dementia other specified cause

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

Dementia unknown or unspecified cause

ICD 11 Code For Dementia unknown or unspecified cause

  6D8Z  Dementia unknown or unspecified cause

Coding Note:

  • This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.
  • When dementia is due to multiple aetiologies, code all that apply.

Other specified neurocognitive disorders

ICD 11 Code For Other specified neurocognitive disorders

  6E0Y  Other specified neurocognitive disorders

Neurocognitive disorders unspecified

ICD 11 Code For Neurocognitive disorders unspecified

  6E0Z  Neurocognitive disorders unspecified

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