Inside Angle
From 3M Health Information Systems
Cloudy with a chance of Brain Fog
Recently, I experienced a period of time when my brain felt fuzzy, or better yet, foggy. And not the kind of fogginess you suffer after a bad night’s sleep or skipping that second cup of coffee, but a persistent, all day haze marked by irritability, lack of energy and inability to focus. That week long (or longer) feeling of being among the walking dead is better known as “Brain Fog.”
Brain fog is not a diagnosis in itself, but rather a collection of symptoms. Some of the more common symptoms are an inability to focus or concentrate, memory deficit, and lack of mental clarity. Patients may also experience irritability, fatigue, low energy or mild depression.
My brain fog was preceded by a highly stressful month coupled with poor diet, lack of sleep, and very little exercise, plus I am sure my pre-existing Hashimoto’s disease did not help. Stress, lack of proper rest, and lack of exercise are common causes of brain fog, but there are many other medical problems that may contribute to the condition. Hypothyroidism, anemia, diabetes, migraine headache and depression have been known to cause brain fog, as well as many auto immune diseases such as lupus, arthritis and multiple sclerosis.
So what ICD-10 code do we report when the diagnosis is brain fog? I, using my brain fog-clouded, curious coder mind went immediately to the ICD-10-CM coding book index and looked under fog….nothing there…then brain… there’s brain death, but I am not that far gone! What’s next? Well, if there is not a code associated with brain fog, we must go with what we do have: the signs and symptoms and/or underlying disease.
If I were to code my brain fog, I would use the following codes:
- E06.3 Hashimoto’s disease*
- R45.4 Irritability
- R41.0 Disorientation (haziness)
- R53.83 Fatigue (lack of energy)
- R41.840 Attention/concentration deficit (inability to focus)
Don’t let your coding judgment get clouded! If you are a little foggy on what code to use, it is important to remember that when there is a lack of a definitive, “codeable” diagnosis, we must rely on what we have. Code underlying conditions, and unless there is a clear connection between a disease process and the symptoms, report both the disease and the signs and symptoms codes.
Gail Barackman is a coding analyst at 3M Health Information Systems.
Should physicians assign their own codes? The benefits and risks.
One thought on “Cloudy with a chance of Brain Fog”
Leave a reply
Gail Barackman, CPC, CPMA, CEMC
Coding Analyst
Gail Barackman, CPC, CPMA, CEMC has over 20 years of experience in the medical coding and billing industry. Expertise in coding and auditing includes Cardiothoracic Surgery, General Surgery, Cardiology, Interventional…
This is fantastic! I couldn’t agree with you more, though my chart would be littered with “F” codes (Psychiatric, Mental Health) after most weeks. Striking a balance, or finding your stride in the midst of this business, is possible. I like to think of it as retraining yourself to breathe…Finding your breath while running uphill so that every muscle, every cell is enabled through the exchange to have oxygen enough to move up to the next level. There’s always a counterpart-the exhale. Of we didnt have the exhale, we’d build up with toxins and ultimately perish. And, so, it is with our lives. We must learn to pace ourselves and retrain how to find our breath.