Current RMA Instruments
| Reasonable Hypothesis SOP | 35 of 2019 |
| Balance of Probabilities SOP | 36 of 2019 |
SOP bulletin information for new SOP
ICD 10 AM Coding
G31.3
Brief description
Neurocognitive disorder with Lewy bodies covers dementia with Lewy bodies and also mild neurocognitive disorder with Lewy bodies. Dementia with Lewy bodies is now recognised to be the third most common type of dementia, after Alzheimer disease and vascular dementia.
Confirming the diagnosis
The diagnosis is made based on the presence of core clinical features on history and examination, including cognitive testing. Distinguishing clinical features (in addition to dementia) include fluctuations in cognition and levels of alertness, visual hallucinations, parkinsonism and sleep (movement) disorders. Neuroimaging may be performed but findings are not diagnostic. The condition can be difficult to diagnose clinically and to distinguish from Alzheimer disease and from Parkinson disease with dementia. The diagnosis can also be confirmed pathologically, at autopsy.
The relevant medical specialist is a neurologist or geriatrician.
Additional diagnoses covered by these SOPs
- Dementia with Lewy bodies
- Major neurocognitive disorder with Lewy bodies
- Mild neurocognitive disorder with Lewy bodies
Conditions not covered by these SOPs
- Alzheimer disease*
- Parkinson disease with Lewy bodies*
- Vascular dementia*
- Multi-infarct dementia* (vascular dementia)
- Frontotemporal dementia#
- Any other identifiable cause of dementia, ICD code as appropriate
* another SOP applies
# non-SOP condition
Clinical onset
Clinical onset will be when symptoms and findings on clinical examination were first sufficent to allow an appropriate medical practitioner to say the condition was present. Onset is typically after age 65.
Clinical worsening
As with other degenerative dementias, cognitive decline in dementia with Lewy bodies progresses inexorably in all patients. There is no treatment available that modifies the course of the condition.