The document outlines the symptoms, diagnosis, treatment, and ICD-10 codes for documenting Parkinson's disease (PD), a progressive neurological disorder characterized by dopamine deficiency. Key symptoms include tremors, rigidity, and movement difficulties, with diagnosis requiring a detailed evaluation and various imaging tests. Accurate coding for PD is essential for medical billing, and outsourcing coding tasks can help physicians manage documentation and reimbursement processes effectively.

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Documenting Parkinson’s
disease (PD) with the Correct
ICD-10 Codes
Outsource Strategies International
8596 E. 101st Street, Suite H
Tulsa, OK 74133
The article lists the symptoms,
diagnosis, and treatment of Parkinson’s
disease along with the ICD-10 codes for
accurately documenting this disorder.

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Parkinson’s disease (PD) is a progressive neurological disorder in which parts of the brain
become progressively damaged over many years. This is a type of movement disorder that
develops when the nerve cells in the brain do not produce enough of a brain chemical called
“dopamine” (which is produced in a part of the brain called the “substantia nigra). The exact
cause of PD is unknown, but several factors like genes, environmental triggers, the presence
of Lewy bodies (within brain cells) and exposure to toxins appear to play a predominant
role. Symptoms develop gradually and may begin with a barely-noticeable tremor in just one
hand. People with PD may also experience stiffness or slowing of movement that may
prevent them from carrying out movements as quickly as before. Although there is no
specific cure for this neurological condition, medications can considerably reduce or
improve the symptoms. Coding for PD can be challenging and for accurate clinical
documentation of this condition, most neurological practices rely on medical coding
outsourcing companies.
Parkinson’s News Today reports that about 10 million people worldwide suffer from this
chronic neurological disorder. It is estimated that approximately 60,000 Americans are
diagnosed with PD each year. PD usually appears between the ages of 50 and 60. Men are
one and a half times more likely to get Parkinson’s disease than women. The potential risk
factors include age, heredity, sex and exposure to toxins.
PD – Signs and Symptoms
Initial symptoms usually appear on one side of your body and continue to become worse
on that side even after symptoms begin to affect both sides. Primary symptoms include –
 Tremor
 Slowed movement (bradykinesia)
 Impaired posture and balance
 Rigid muscles
 Loss of automatic movements
Secondary symptoms of PD include –
 Blank facial expression
 A tendency to stoop or lean forward
 Cramping
 Writing and speech changes
 Swallowing difficulties (dysphagia)
 Decreased blinking and swallowing
 Reduced arm swinging when walking
 Involuntary movements and prolo-nged muscle contractions (dystonia)

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 Drooling
 Fatigue
 Sexual dysfunction
Other signs and symptoms include - sleep problems, dementia, constipation, urinary
incontinence, reduced sensation of pain and problems with attention and memory.
Diagnosis and Evaluation
There is no specific test to diagnose Parkinson’s disease. A primary care physician or
general practitioner will be usually the first healthcare professional to evaluate the
symptoms. A detailed evaluation will be done by analyzing the initial signs and symptoms
and examining the previous medical history of the patient. Generally, the symptoms will be
mild during the early stages of PD and physicians may find it hard to definitively diagnose
the condition. However, if Parkinson’s disease is suspected, the general physician will
directly refer the patient to a neurologist.
Based on patient medical history, the neurologist will conduct a detailed review of
symptoms along with a neurological and physical examination. Several diagnostic imaging
tests such as MRI scan, CT scan, Single-photon emission computerized tomography
(SPECT) scan, Ultrasound of the brain, Positron emission tomography (PET) scan, and
blood tests may be performed to analyze symptoms and rule out other disorders.
Treatment Methods for PD
Treatment methods include medications and incorporating several positive lifestyle
changes. Medications like Carbidopa-levodopa, Dopamine agonists, Anticholinergics,
Amantadine and MAO-B and COMT inhibitors will help people manage problems with
walking, movement and tremor. These medications also increase or substitute for
dopamine, a specific signaling chemical (neurotransmitter) in the brain. Taking adequate
rest, exercise and consuming a balanced diet are important. Speech therapy, occupational
therapy, and physical therapy can also help to improve communication and other related
symptoms. Surgical interventions like deep brain stimulation (DBS) will be considered as a
last resort for those patients who normally don’t respond to medications, therapies and
other lifestyle changes.
ICD-10 Codes for Parkinson’s disease
Neurologists who treat Parkinson’s patients must maintain clear and complete records
about their diagnosis and treatment services provided. Neurology medical coding involves
using the correct ICD-10 codes to report PD on the medical claims they submit to health
insurers for reimbursement.

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Clinical documentation must also mention the specific type of Parkinson’s disease. The
following ICD-10 codes are used to indicate a diagnosis of PD for reimbursement purposes
–
G20 – Parkinson’s disease
ICD-10-CM code G20 is a specific code that can be used to specify a diagnosis and is
applicable to –
 Hemiparkinsonism
 Idiopathic Parkinsonism or Parkinson’s disease
 Paralysis agitans
 Parkinsonism or Parkinson’s disease NOS
 Primary Parkinsonism or Parkinson’s disease
G21 – Secondary parkinsonism
 G21.0 – Malignant neuroleptic syndrome
 G21.1 – Other drug-induced secondary parkinsonism
G21.11 – Neuroleptic induced parkinsonism
 G21.19 – Other drug induced secondary parkinsonism
 G21.2 – Secondary parkinsonism due to other external agents
 G21.3 – Postencephalitic parkinsonism
 G21.4 – Vascular parkinsonism
 G21.8 – Other secondary parkinsonism
 G21.9 – Secondary parkinsonism, unspecified
Exclusion specific to G20: ‘Dementia with Parkinsonism’ is not included in the above set
and has to be coded using G31.83.
If you are diagnosed with Parkinson's disease (PD), it is important to work closely with
your physician to discuss the type of treatment modality you should follow. Appropriate
and timely treatment can help to reduce the intensity of PD. A combination of medications
followed by certain lifestyle changes such as healthy eating, regular physical exercise and
avoiding falls may help make living with Parkinson's disease easier.
Treating and managing patients with Parkinson’s disease and taking care of the essential
documentation requirements can be quite challenging for physicians. Managing neurology
medical billing and coding tasks could be easier for physicians who partner with a
professional medical billing and coding company that provides the services of AAPC-
certified coding specialists.