Question

Using the techniques described in this chapter carefully read through the case study and determine the most accurate ICD-10-CM code(s) and external cause code(s) if appropriate. Remember, check the chapter specific, sub-chapter specific and category specific notations within the Tabular list. Patient: Gerald Young Physician: Hannah Cohen, MD This 37-year-old man presents to the psychiatry emergency room for inappropriate behavior and confusion. He works as a janitor and has had reasonably good work attendance. His coworkers say that he has appeared “fidgety” for several years. They specifically mention jerky movements that seem to affect his entire body more recently. His mother is alive and well, although his father died at age 28 in an auto accident. On examination, he is alert but easily distracted. His speech is fluent without paraphasias but is noted to be tangential. He has trouble with spelling the word “world” backwards and serial seven’s, but recalls three objects at 3 minutes. His constructions are good. When he walks, there is a lot of distal hand movement, and his balance is precarious, although he can stand with both feet together. His reflexes are increased bilaterally, and there is bilateral ankle clonus. A urine drug screen is negative. Most likely diagnosis: Huntington disease. Next diagnostic step: Genetic counseling and genetic testing for Huntington disease. Review the history very carefully with patient and his relatives and assess medications—either illicit or licit that could be responsible. Molecular or genetic basis: Repeat CAG triplets present in a gene called huntingtin located on chromosome 4p16.3. Repeat lengths greater than 40 are nearly always associated with clinical Huntington’s disease. Confirmed Huntington’s disease. Be sure to list the codes, one code per box, in the correct order, from top to bottom. Capitalization, punctuation, and spacing can impact whether or not your answer is correct. Follow coding best practices. What is/are the correct diagnosis code(s)?

Answer 1

Answer

S.No	Disease Condition	Code(ICD)
1.	Disease of nervous system Huntington disease	G10
2.	Dementia in Huntington disease	F02.2
3.	Choreic disorder	F02.0, F02.1