General paresis

General paresis, also known as paretic neurosyphilis or dementia paralytica, is a severe, chronic neuropsychiatric manifestation of late-stage syphilis. It is characterized by progressive cognitive decline, personality changes, psychiatric symptoms (e.g., delusions, hallucinations), and neurological deficits such as tremors, ataxia, and pupillary abnormalities. This condition results from chronic inflammation and damage to the brain and spinal cord caused by Treponema pallidum infection.

This code is appropriate for documenting a confirmed diagnosis of general paresis in patients with a history of syphilis, often many years after the initial infection. Documentation should clearly indicate the neurological and psychiatric symptoms consistent with this specific form of neurosyphilis, supported by clinical findings, serological tests (e.g., VDRL, RPR, FTA-ABS), and sometimes cerebrospinal fluid analysis.

• Ensure documentation explicitly states "general paresis" or "paretic neurosyphilis" to support this specific code.
• Do not use this code for other forms of neurosyphilis; refer to the ICD-10-CM index for more specific codes.
• Consider sequencing this code after the primary reason for the encounter if the patient is being treated for complications or specific symptoms of general paresis.