NMQF Praises CMS New ICD-10 Codes for the Treatment of Dementia and Alzheimer’s Disease

On August 2, 2022, the Centers for Medicare and Medicaid Services announced the release of the FY2023 ICD-10-CM Code Files. The NMQF National Alliance for Brain Health and Awareness is pleased that the coding proposal produced by our ICD-10-CM Coding Initiative for the Neuropsychiatric Symptoms of Dementia and Stages of Severity of Alzheimer’s Disease is included in the FY2023 ICD-10-CM Code Files.

This 3-year multi-stakeholder collaboration enabled by the National Alliance for Brain Health and Awareness was informed by the invaluable perspectives of the following clinical and scientific advisors: David S. Geldmacher, MD, FANA, FACP; Maureen Nash, MD, MS, FAPA, FACP; and Amita Patel, MD, CMD, MHA, CPE. The initiative also coordinated with the American Psychiatric Association and the American Association for Geriatric Psychiatry.

Dementia, also known as major neurocognitive disorder, is characterized by a significant decline in cognitive functions such as memory, problem-solving, attention, and language skills. It is generally due to an underlying disorder such as cerebrovascular disease or Alzheimer’s disease, although a specific underlying disorder sometimes cannot be identified. Prior to this coding update, the codes for dementia did not identify the stage of severity and did not fully identify behavioral and psychological symptoms of dementia (BPSD). Both of these clinical elements are major factors in patient management strategies. Particularly because dementia is progressive, there is a great need for longitudinal clinical data to capture the stage of severity and the key associated disorders over time to move research and clinical studies forward. The new enhanced coding in the FY 2023 ICD-10-CM Files will help to enable recognition of the appropriate management strategies for interventions as well as the development of new non-pharmacological and pharmacological approaches to improve the adverse outcomes.

As noted in the August 2, 2022 CMS announcement, the FY 2023 Code Tables, Tabular and Index files, which contain information on the ICD-10-CM updates for FY 2023, are available in the Downloads section at: https://www.cms.gov/medicare/icd-10/2023-icd-10-cm. These FY 2023 ICD-10-CM codes are to be used for discharges occurring from October 1, 2022 through September 30, 2023, and for patient encounters occurring from October 1, 2022 through September 30, 2023. All diagnosis code files are also available via the CDC/NCHS website at: https://www.cdc.gov/nchs/icd/icd-10-cm.htm. Any questions related to the content of these diagnosis code files should be directed to the CDC/NCHS at nchsicd10cm@cdc.gov.  

The National Alliance for Brain Health and Awareness was established to strengthen the American health services policy infrastructure in a manner that supports the reduction of patient risk associated with the late or inadequate diagnosis of behavioral health and brain health conditions. We believe that these new codes are an essential component of a forward-looking screening, diagnosis, and treatment construct that reduces patient risk and enables the development of new and more precise science.

NMQF will continue its mission to identify opportunities to reorient the U.S. health services policy and regulatory infrastructure toward the reduction of patient risk. Please direct any questions about our coding initiative to Gretchen C. Wartman, Director, National Alliance for Brain Health and Awareness, and NMQF Vice President for Policy and Program, at gwartman@nmqf.org.