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ICD-10 Guide
ICD-10 CodesG31.1

G31.1

Billable

Senile degeneration of brain, not elsewhere classified

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 G31.1 is a billable code used to indicate a diagnosis of senile degeneration of brain, not elsewhere classified.

Key Diagnostic Point:

Senile degeneration of the brain, classified under ICD-10 code G31.1, refers to a group of neurodegenerative disorders characterized by progressive cognitive decline and brain atrophy, primarily affecting the elderly population. This condition encompasses various forms of dementia, including Alzheimer's disease, which is the most prevalent type. Patients typically present with memory loss, impaired reasoning, and changes in behavior, which can significantly impact daily functioning. The pathophysiology involves the accumulation of abnormal proteins, such as amyloid plaques and tau tangles, leading to neuronal death and synaptic dysfunction. Diagnosis is primarily clinical, supported by neuroimaging and cognitive assessments. It is crucial to differentiate G31.1 from other specific degenerative diseases and dementias, as treatment and management strategies may vary. The condition is often associated with other comorbidities, necessitating comprehensive assessment and management strategies to improve patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other types of dementia (e.g., Alzheimer's, vascular dementia)
  • Need for comprehensive clinical documentation to support diagnosis
  • Variability in presentation and progression of symptoms
  • Potential for overlapping symptoms with other neurological conditions

Audit Risk Factors

  • Inadequate documentation of cognitive assessments
  • Failure to specify the type of degenerative disease
  • Lack of supporting neuroimaging results
  • Misclassification of symptoms as normal aging

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, cognitive assessment results, and neuroimaging reports.

Common Clinical Scenarios

Patients presenting with memory loss, confusion, and behavioral changes.

Billing Considerations

Ensure that all cognitive decline assessments are documented and that differential diagnoses are considered.

Geriatrics

Documentation Requirements

Comprehensive geriatric assessments including functional status, comorbidities, and social history.

Common Clinical Scenarios

Elderly patients with progressive cognitive decline and functional impairment.

Billing Considerations

Focus on the impact of cognitive decline on daily living activities and the need for support services.

Coding Guidelines

Inclusion Criteria

Use G31.1 When
  • According to ICD
  • 10 coding guidelines, G31
  • 1 should be used when the specific type of senile degeneration is not classified elsewhere
  • Coders must ensure that the diagnosis is supported by clinical documentation and that other potential causes of cognitive decline are ruled out

Exclusion Criteria

Do NOT use G31.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

96136CPT Code

Neuropsychological testing

Clinical Scenario

Used to assess cognitive function in patients suspected of having senile degeneration.

Documentation Requirements

Document the specific tests performed and the results.

Specialty Considerations

Neurologists should ensure comprehensive testing to support the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of neurodegenerative diseases, improving the ability to capture the complexity of conditions like senile degeneration of the brain. This specificity aids in better patient management and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of neurodegenerative diseases, improving the ability to capture the complexity of conditions like senile degeneration of the brain. This specificity aids in better patient management and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of neurodegenerative diseases, improving the ability to capture the complexity of conditions like senile degeneration of the brain. This specificity aids in better patient management and resource allocation.

Resources

Clinical References

  • •
    Alzheimer's Association
  • •
    American Academy of Neurology

Coding & Billing References

  • •
    Alzheimer's Association
  • •
    American Academy of Neurology

Frequently Asked Questions

What is the difference between G31.1 and G30?

G31.1 is used for senile degeneration of the brain not classified elsewhere, while G30 specifically refers to Alzheimer's disease. Accurate coding depends on the specific diagnosis made by the clinician.