ECT and dementia

In my last post I mentioned the Atos Evidence Based Protocol for the Disability Analyst on depression. On the subject of electroconvulsive therapy (ECT) this document states“There is no evidence that it causes brain damage or permanent intellectual impairment”. However, a recent request for help from a member of the American Association of Professional Coders (AAPC) on the AAPC forum offers a glimpse of the damage, so seldom acknowledged, that ECT can do. The request asked how dementia due to ECT should be coded. Apparently the physician had made a diagnosis of dementia following ECT. In reply someone suggested: 999.9 followed by 294.10, E873.4 and E849.7.  Now, according to find-a-code, these codes translate as:

999.9 – Other and unspecified complications of medical care, not elsewhere classified, Unspecified misadventure of medical care

294.10 – Dementia in conditions classified elsewhere without behavioral disturbance

E873.4 – Failure in dosage in electroshock or insulin-shock therapy

E849.7 – Accident in residential institution

I do not have a subscription to this website so these are only the abbreviated explanations. But the stark fact of dementia due to ECT seems to have lost – or gained – something in the coding with its talk about failure in dosage, accident and misadventure.

There is of course a lot between dementia and “no intellectual impairment”, any number of degrees of impairment that can have an impact on a person’s life to a greater or lesser extent.

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