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.