Cognition assessed and reviewed (DEM)
CPT4 code
Name of the Procedure:
Cognition Assessed and Reviewed (DEM) Common name(s): Cognitive Assessment, Cognitive Review, Cognitive Evaluation
Summary
Cognition Assessed and Reviewed involves a series of tests and evaluations to gauge cognitive functions such as memory, attention, problem-solving, and language abilities. These assessments help detect any cognitive impairments or changes over time.
Purpose
Medical Condition or Problem: Cognitive decline, memory loss, Alzheimer's disease, dementia, and other neurocognitive disorders.
Goals/Expected Outcomes: The goal is to identify cognitive dysfunction, monitor changes in cognitive abilities, and inform treatment strategies.
Indications
Symptoms/Conditions: Memory lapses, difficulty concentrating, trouble executing everyday tasks, confusion, difficulty with language or following instructions.
Patient Criteria: Usually recommended for elderly patients, those with head trauma, or individuals showing signs of cognitive decline.
Preparation
Pre-procedure Instructions: Ensure a well-rested state, adequate hydration, and a clear mind. Patients might be asked to bring a list of current medications.
Diagnostic Tests Required: Sometimes, preliminary screening such as MRI or blood tests may be recommended to rule out other causes of cognitive issues.
Procedure Description
- Interview: The healthcare professional will start with a detailed medical and family history.
- Cognitive Tests: Standardized tests like the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), or Dementia Rating Scale (DRS) are administered.
- Behavioral Observations: The professional will observe the patient's behavior and interactions during the assessment.
Tools Used: Printed tests, pencils, computers, and sometimes specialized software for cognitive testing.
Anesthesia/Sedation Details: Not applicable; this is a non-invasive procedure.
Duration
Typically, the assessment takes about 1-2 hours.
Setting
Performed in an outpatient clinic, hospital, or specialized cognitive assessment center.
Personnel
Healthcare professionals including neuropsychologists, neurologists, and trained cognitive assessment personnel.
Risks and Complications
Common Risks: Minimal risk. Some patients may experience anxiety or fatigue. Rare Risks: None noted. The procedure is non-invasive and safe.
Benefits
Identifies cognitive issues early, aiding in effective management. Provides a baseline for monitoring changes over time. Can guide treatment and care strategies quickly.
Recovery
No recovery time needed. Patients can return to their regular activities immediately after the assessment.
Post-Procedure Care: None required. Follow-up appointments might be scheduled to discuss results.
Alternatives
Other Options:
- Neuroimaging: MRI or CT scans can be used to visualize brain structures.
- Blood Tests: To rule out metabolic causes of cognitive issues.
- Functional Assessments: Evaluations focusing on daily living activities.
Pros and Cons of Alternatives:
- Neuroimaging: Provides structural details but may not reveal functional impairments.
- Blood Tests: Useful for underlying conditions but doesn’t directly assess cognitive function.
- Functional Assessments: Helps in understanding real-world implications but might not pinpoint specific cognitive deficits.
Patient Experience
Patients might feel nervous or stressed during testing but are often made comfortable through breaks and supportive encouragement. Pain management is not needed, and the environment is typically calm and quiet to ensure accurate assessment.