Saturday, 28 May 2022

ICD-11 Criteria for Dementia due to Psychoactive Substances Including Medications (6D84)

ICD-11 Criteria for Dementia due to Psychoactive Substances Including Medications (6D84)

Dementia due to psychoactive substances including medications includes forms of dementia that are judged to be a direct consequence of substance use and that persist beyond the usual duration of action or withdrawal syndrome associated with the substance. The amount and duration of substance use must be sufficient to produce the cognitive impairment. The cognitive impairment is not better accounted for by a disorder that is not induced by substances such as a dementia due to another medical condition.

Coding Note:     This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.

When dementia is due to multiple aetiologies, code all that apply.

Exclusions:   

Dementia due to exposure to heavy metals and other toxins (6D85.2)

6D84.0        Dementia due to use of alcohol

Dementia due to use of alcohol is characterised by the development of persistent cognitive impairments (e.g., memory problems, language impairment, and an inability to perform complex motor tasks) that meet the definitional requirements of Dementia that are judged to be a direct consequence of alcohol use and that persist beyond the usual duration of alcohol intoxication or acute withdrawal. The intensity and duration of alcohol use must have been sufficient to produce the cognitive impairment. The cognitive impairment is not better accounted for by a disorder or disease that is not induced by alcohol such as a dementia due to another disorder or disease classified elsewhere.

Coding Note:     This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.

When dementia is due to multiple aetiologies, code all that apply.

This category should not be used to describe cognitive changes due to thiamine deficiency associated with chronic alcohol use.

Inclusions: 

Alcohol-induced dementia

Exclusions: 

Wernicke-Korsakoff Syndrome (5B5A.1)

Korsakoff syndrome (5B5A.11)

6D84.1          Dementia due to use of Sedatives, Hypnotics or Anxiolytics

Dementia due to use of sedatives, hypnotics or anxiolytics is characterised by the development of persistent cognitive impairments (e.g., memory problems, language impairment, and an inability to perform complex motor tasks) that meet the definitional requirements of Dementia that are judged to be a direct consequence of sedative, hypnotic, or anxiolytic use and that persist beyond the usual duration of action or withdrawal syndrome associated with the substance. The amount and duration of sedative, hypnotic, or anxiolytic use must be sufficient to produce the cognitive impairment. The cognitive impairment is not better accounted for by a disorder that is not induced by sedatives, hypnotics, or anxiolytics such as a dementia due to another medical condition.

Coding Note:     This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.

When dementia is due to multiple aetiologies, code all that apply.

Inclusions:

Late-onset psychoactive substance-induced psychotic disorder

6D84.2         Dementia due to use of volatile inhalants

Dementia due to use of volatile inhalants is characterised by the development of persistent cognitive impairments (e.g., memory problems, language impairment, and an inability to perform complex motor tasks) that meet the definitional requirements of Dementia that are judged to be a direct consequence of inhalant use or exposure and that persist beyond the usual duration of action or withdrawal syndrome associated with the substance. The amount and duration of inhalant use or exposure must be sufficient to be capable of producing the cognitive impairment. The cognitive impairment is not better accounted for by a disorder that is not induced by volatile inhalants such as a dementia due to another medical condition.

Coding Note:     This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.

When dementia is due to multiple aetiologies, code all that apply.

6D84.Y         Dementia due to other specified psychoactive substance

Coding Note:     This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.

When dementia is due to multiple aetiologies, code all that apply.


REFERENCE:

International Classification of Diseases Eleventh Revision (ICD-11). Geneva: World Health Organization; 2022. License: CC BY-ND 3.0 IGO.

https://creativecommons.org/licenses/by-nc-nd/3.0/igo/


ICD-11 Criteria for Dementia due to Alzheimer Disease (6D80)

ICD-11 Criteria for Dementia due to Alzheimer Disease (6D80)

Dementia due to Alzheimer disease is the most common form of dementia. Onset is insidious with memory impairment typically reported as the initial presenting complaint. The characteristic course is a slow but steady decline from a previous level of cognitive functioning with impairment in additional cognitive domains (such as executive functions, attention, language, social cognition and judgment, psychomotor speed, visuoperceptual or visuospatial abilities) emerging with disease progression. Dementia due to Alzheimer disease may be accompanied by mental and behavioural symptoms such as depressed mood and apathy in the initial stages of the disease and may be accompanied by psychotic symptoms, irritability, aggression, confusion, abnormalities of gait and mobility, and seizures at later stages. Positive genetic testing, family history and gradual cognitive decline are suggestive of Dementia due to Alzheimer disease.

Coding Note:     This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.

6D80.0        Dementia due to Alzheimer disease with early onset

Dementia due to Alzheimer disease in which symptoms emerge before the age of 65 years. It is relatively rare, representing less than 5% of all cases, and may be genetically determined (autosomal dominant Alzheimer disease). Clinical presentation may be similar to cases with later onset, but progression of cognitive deficits may be more rapid.

Coding Note:     This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.

When dementia is due to multiple aetiologies, code all that apply.

6D80.1        Dementia due to Alzheimer disease with late onset

Dementia due to Alzheimer disease that develops at the age of 65 years or above. This is the most common pattern, representing more than 95% of all cases.

Coding Note:     This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.

When dementia is due to multiple aetiologies, code all that apply.

6D80.2         Alzheimer disease dementia, mixed type, with cerebrovascular disease

Dementia due to Alzheimer disease and concomitant cerebrovascular disease.

Coding Note:     This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.

When dementia is due to multiple aetiologies, code all that apply.

6D80.3        Alzheimer disease dementia, mixed type, with other nonvascular aetiologies

Dementia due to Alzheimer disease with other concomitant pathology, not including cerebrovascular disease.

Coding Note:     This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.

When dementia is due to multiple aetiologies, code all that apply.

6D80.Z          Dementia due to Alzheimer disease, onset unknown or unspecified

Coding Note:     This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere.


REFERENCE:

International Classification of Diseases Eleventh Revision (ICD-11). Geneva: World Health Organization; 2022. License: CC BY-ND 3.0 IGO.

https://creativecommons.org/licenses/by-nc-nd/3.0/igo/


ICD-11 Criteria for Amnestic Disorder (6D72)

ICD-11 Criteria for Amnestic Disorder (6D72)

Prominent memory impairment relative to expectations for age and general premorbid level of cognitive functioning, which represents a decline from the individual’s previous level of functioning characterizes amnestic disorder, in the absence of other significant cognitive impairment. It is manifested by a deficit in acquiring, learning, and/or retaining new information, and may include the inability to recall previously learned information, without disturbance of consciousness, altered mental status, or delirium. Recent memory is typically more disturbed than remote memory, and the ability to immediately recall a limited amount of information is usually relatively preserved. The memory impairment is severe enough to result in significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. It is is presumed to be attributable to an underlying acquired disease of the nervous system, a trauma, an infection or other disease process affecting the brain, to use of specific substances or medications, nutritional deficiency or exposure to toxins, or the etiology may be undetermined. The impairment is not due to current substance intoxication or withdrawal.

Exclusions:             

Delirium (6D70)

Dementia (BlockL2‑6D8)

Mild neurocognitive disorder (6D71)

 

6D72.0                    Amnestic disorder due to diseases classified elsewhere

All definitional requirements for amnestic disorder are met. The memory symptoms are judged to be the direct pathophysiological consequence of a medical condition not classified under mental, behavioural and neurodevelopmental disorders, based on evidence from the history, physical examination, or laboratory findings. The symptoms are not better explained by Delirium, Dementia, another mental disorder (e.g., Schizophrenia or Other Primary Psychotic Disorder, a Mood Disorder) or the effects of a medication or substance, including withdrawal effects. The symptoms are sufficiently severe to be a specific focus of clinical attention. The identified etiological medical condition should be classified separately.

Coding Note:     Code aslo the causing condition

Exclusions:             

amnesia: retrograde (MB21.11)

Korsakoff syndrome, alcohol-induced or unspecified (8D44)

Dissociative amnesia (6B61)

Anterograde amnesia (MB21.10)

amnesia NOS (MB21.1)

 

6D72.1      Amnestic disorder due to psychoactive substances including medications

I met all definitional requirements for amnestic disorder. The memory symptoms are judged to be the direct consequence of psychoactive substance use. The intensity and duration of substance use must be known to be capable of producing memory impairment. The memory impairment may develop during or soon after substance intoxication or withdrawal, but its intensity and duration are substantially in excess of those normally associated with these conditions. The symptoms are not better accounted for by another disorder or medical condition, as might be the case if the amnestic symptoms preceded the onset of substance use.

Coding Note:   Code aslo the causing condition

 

6D72.10            Amnestic disorder due to use of alcohol

All definitional requirements for amnestic disorder are met. The memory symptoms are judged to be the direct consequence of alcohol use. The intensity and duration of alcohol use must be known to be capable of producing memory impairment. The memory impairment may develop during or soon after alcohol intoxication or withdrawal, but its intensity and duration are substantially in excess of those normally associated with these conditions. The symptoms are not better accounted for by another disorder or medical condition, as might be the case if the amnestic symptoms preceded the onset of the alcohol use.

Coding Note:  This category should not be used to describe cognitive changes due to thiamine deficiency associated with chronic alcohol use.

Exclusions:

Korsakoff syndrome (5B5A.11)

Wernicke-Korsakoff Syndrome (5B5A.1)

 

6D72.11       Amnestic disorder due to use of sedatives, hypnotics or anxiolytics

All definitional requirements for amnestic disorder are met. The memory symptoms are judged to be the direct consequence of use of sedatives, hypnotics or anxiolytics. The intensity and duration of use of sedatives, hypnotics or anxiolytics must be known to be capable of producing memory impairment. The memory impairment may develop during or soon after sedative, hypnotic or anxiolytic intoxication or withdrawal, but its intensity and duration are substantially in excess of those normally associated with these conditions. The symptoms are not better accounted for by another disorder or medical condition, as might be the case if the amnestic symptoms preceded the onset of use of sedatives, hypnotics or anxiolytics.

Coding Note:     Code aslo the causing condition

 

6D72.12        Amnestic disorder due to other specified psychoactive substance including medications

All definitional requirements for amnestic disorder are met. The memory symptoms are judged to be the direct consequence of use of a specified psychoactive substance other than alcohol; sedatives, hypnotics or anxiolytics; or volatile inhalants. The intensity and duration of use of the specified psychoactive substance must be known to be capable of producing memory impairment. The memory impairment may develop during or soon after specified psychoactive substance intoxication or withdrawal, but its intensity and duration are substantially in excess of those normally associated with these conditions. The symptoms are not better accounted for by another disorder or medical condition, as might be the case if the amnestic symptoms preceded the onset of the specified psychoactive substance.

 

6D72.13                  Amnestic disorder due to use of volatile inhalants

All definitional requirements for amnestic disorder are met. The memory symptoms are judged to be the direct consequence of use of volatile inhalants. The intensity and duration of use of volatile inhalants must be known to be capable of producing memory impairment. The memory impairment may develop during or soon after volatile inhalant intoxication or withdrawal, but its intensity and duration are substantially in excess of those normally associated with these conditions. The symptoms are not better accounted for by another disorder or medical condition, as might be the case if the amnestic symptoms preceded the onset of use of volatile inhalants.

 

6D72.2        Amnestic disorder due to unknown or unspecified aetiological factors

All definitional requirements for amnestic disorder are met. The specific etiology of the disorder is unspecified or cannot be determined.

6D72.Y          Amnestic disorder, other specified cause
6D72.Z          Amnestic disorder, unknown or unspecified cause

REFERENCE:

International Classification of Diseases Eleventh Revision (ICD-11). Geneva: World Health Organization; 2022. License: CC BY-ND 3.0 IGO.
https://creativecommons.org/licenses/by-nc-nd/3.0/igo/

ICD-11 Criteria for Paraphilic Disorder Involving Solitary Behaviour or Consenting Individuals (6D36)

ICD-11 Criteria for Paraphilic Disorder Involving Solitary Behaviour or Consenting Individuals (6D36)

Paraphilic disorder involving solitary behaviour or consenting individuals is characterised by a persistent and intense pattern of atypical sexual arousal— manifested by sexual thoughts, fantasies, urges, or behaviours— that involves consenting adults or solitary behaviours. One of the following two elements must be present: 1) the person is markedly distressed by the nature of the arousal pattern and the distress is not simply a consequence of rejection or feared rejection of the arousal pattern by others; or 2) the nature of the paraphilic behaviour involves significant risk of injury or death either to the individual or to the partner (e.g., asphyxophilia).

6D3Z        Paraphilic Disorders, Unspecified

REFERENCE:

International Classification of Diseases Eleventh Revision (ICD-11). Geneva: World Health Organization; 2022. License: CC BY-ND 3.0 IGO.

https://creativecommons.org/licenses/by-nc-nd/3.0/igo/


ICD-11 Criteria for Factitious Disorder Imposed on Another (6D51)

ICD-11 Criteria for Factitious Disorder Imposed on Another (6D51)

Factitious disorder imposed on another is characterised by feigning, falsifying, or inducing, medical, psychological, or behavioural signs and symptoms or injury in another person, most commonly a child dependent, associated with identified deception. If a pre-existing disorder or disease is present in the other person, the individual intentionally aggravates existing symptoms or falsifies or induces additional symptoms. The individual seeks treatment for the other person or otherwise presents him or her as ill, injured, or impaired based on the feigned, falsified, or induced signs, symptoms, or injuries. The deceptive behaviour is not solely motivated by obvious external rewards or incentives (e.g., obtaining disability payments or avoiding criminal prosecution for child or elder abuse).

Coding Note:     The diagnosis of Factitious Disorder Imposed on Another is assigned to the individual who is feigning, falsifying or inducing the symptoms in another person, not to the person who is presented as having the symptoms. Occasionally the individual induces or falsifies symptoms in a pet rather than in another person.

Exclusions:             

Malingering (QC30)

6D5Z          Factitious Disorders, Unspecified


REFERENCE:

International Classification of Diseases Eleventh Revision (ICD-11). Geneva: World Health Organization; 2022. License: CC BY-ND 3.0 IGO.

https://creativecommons.org/licenses/by-nc-nd/3.0/igo/


ICD-11 Criteria for Neurocognitive Disorders (BlockL1‑6D7)

ICD-11 Criteria for Neurocognitive Disorders (BlockL1‑6D7)

Neurocognitive disorders are characterised by primary clinical deficits in cognitive functioning that are acquired rather than developmental. That is, neurocognitive disorders do not include disorders characterised by deficits in cognitive function that are present from birth or that typically arise during the developmental period, which are classified in the grouping neurodevelopmental disorders. Rather, neurocognitive disorders represent a decline from a previously attained level of functioning. Although cognitive deficits are present in many mental disorders (e.g., schizophrenia, bipolar disorders), only disorders whose core features are cognitive are included in the neurocognitive Disorders grouping. In cases where the underlying pathology and etiology for neurocognitive disorders can be determined, the identified etiology should be classified separately.

Exclusions:

Neurodevelopmental disorders (BlockL1‑6A0)

Coded Elsewhere:  Secondary neurocognitive syndrome (6E67)

6D70        Delirium

Delirium is characterized by a disturbance of attention, orientation, and awareness that develops within a short period of time, typically presenting as significant confusion or global neurocognitive impairment, with transient symptoms that may fluctuate depending on the underlying causal condition or etiology. Delirium often includes disturbance of behaviour and emotion, and may include impairment in multiple cognitive domains. A disturbance of the sleep-wake cycle, including reduced arousal of acute onset or total sleep loss with reversal of the sleep-wake cycle, may also be present. Delirium may be caused by the direct physiological effects of a medical condition not classified under mental, behavioural or neurodevelopmental disorders, by the direct physiological effects of a substance or medication, including withdrawal, or by multiple or unknown etiological factors.

6D70.0        Delirium due to disease classified elsewhere

All definitional requirements for delirium are met. There is evidence from history, physical examination, or laboratory findings that Delirium is caused by the direct physiological consequences of a disorder or disease classified elsewhere.

Coding Note:     Identified etiology should be classified separately.

6D70.1         Delirium due to psychoactive substances including medications

All definitional requirements for delirium are met. There is evidence from history, physical examination, or laboratory findings that the delirium is caused by the direct physiological effects of a substance or medication (including withdrawal). If the specific substance inducing the delirium has been identified, it should be classified using the appropriate subcategory (e.g., alcohol-induced delirium).

Coded Elsewhere:  Alcohol-induced delirium (6C40.5)

Cannabis-induced delirium (6C41.5)

Synthetic cannabinoid-induced delirium (6C42.5)

Opioid-induced delirium (6C43.5)

Sedative, hypnotic or anxiolytic-induced delirium (6C44.5)

Cocaine-induced delirium (6C45.5)

Stimulant-induced delirium including amphetamines, methamphetamine or methcathinone (6C46.5)

Synthetic cathinone-induced delirium (6C47.5)

Hallucinogen-induced delirium (6C49.4)

Volatile inhalant-induced delirium (6C4B.5)

MDMA or related drug-induced delirium, including MDA (6C4C.5)

Dissociative drug-induced delirium including ketamine or PCP (6C4D.4)

Delirium induced by other specified psychoactive substance including medications (6C4E.5)

Delirium induced by multiple specified psychoactive substances including medications (6C4F.5)

Delirium induced by unknown or unspecified psychoactive substance (6C4G.5)

6D70.2        Delirium due to multiple etiological factors

All definitional requirements for delirium are met. There is evidence from history, physical examination, or laboratory findings that the delirium is attributable to multiple etiological factors, which may include disorders or diseases not classified under mental and behavioural disorders, substance intoxication or withdrawal, or a medication.

Coding Note:     Identified etiologies should be classified separately.

6D70.Y         Delirium, other specified cause

6D70.Z         Delirium, unspecified or unknown cause


REFERENCE:

International Classification of Diseases Eleventh Revision (ICD-11). Geneva: World Health Organization; 2022. License: CC BY-ND 3.0 IGO.

https://creativecommons.org/licenses/by-nc-nd/3.0/igo/


ICD-11 Criteria for Mild Neurocognitive Disorder (6D71)

ICD-11 Criteria for Mild Neurocognitive Disorder (6D71)

Mild neurocognitive disorder is characterized by mild impairment in one or more cognitive domains relative to that expected given the individual’s age and general premorbid level of cognitive functioning, which represents a decline from the individual’s previous level of functioning. Diagnosis is based on report from the patient, informant, or clinical observation, and is accompanied by objective evidence of impairment by quantified clinical assessment or standardized cognitive testing. Cognitive impairment is not severe enough to significantly interfere with an individual’s ability to perform activities related to personal, family, social, educational, and/or occupational functioning or other important functional areas. Cognitive impairment is not attributable to normal aging and may be static, progressive, or may resolve or improve depending on underlying cause or treatment. Cognitive impairment may be attributable to an underlying acquired disease of the nervous system, a trauma, an infection or other disease process affecting the brain, use of specific substances or medications, nutritional deficiency or exposure to toxins, or the etiology may be undetermined. The impairment is not due to current substance intoxication or withdrawal.

Coding Note:     Code aslo the causing condition


REFERENCE:

International Classification of Diseases Eleventh Revision (ICD-11). Geneva: World Health Organization; 2022. License: CC BY-ND 3.0 IGO.

https://creativecommons.org/licenses/by-nc-nd/3.0/igo/


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