Mental Incompetency
Could someone please tell me what ICD-10 code is used if a person has been deemed "Mentally Incompetent"?
Wasn't there a Coding Clinic several years ago when the diagnosis of Mental Incompetent was changed to "Intellectual Disability"? Or am I dreaming ?
Thank you in advance,
Melody Brown, RHIA
Clinical Documentation Integrity Specialist
Comments
My thoughts, suggestion: Mental incompetence is a legal concept. Code the the condition that is the etiology: intellectual disability, cognitive impairment, psych disorder, etc. May want to consider also assigning Z02.71 or Z04.6.
Other thoughts?
The capacity to make medical decisions is a legal framework that should be supported by documentation of the medical or psychiatric condition that is causing the incapacity. It is not a static concept and can shift fluidly from hour to hour. Additionally, depending on your state laws, there may be legal filings necessary to justify your actions. A patient's right to self determination outweighs what we think is best for them. It is a legal conundrum that has to be looked at on a case by case basis, minute by minute even. The impact on inpatient is in the diagnosis, not their capacity. to make medical decisions. Of course for outpatient treatment, the E/M level might be more complicated as a result of the need for communication with guardian or family.