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Sunday, July 24, 2011

The Wandering Code

Wandering has been an issue in the autism community. From the Centers for Disease Control:

The ICD-9-CM code for wandering Description: Adobe PDF file, effective October 1, 2011, is designed to promote better data collection for and understanding of wandering and to prompt important discussions about safety among healthcare providers, caregivers, and the person with a disability to the fullest extent possible.

Wandering places children and adults with autism spectrum disorders (ASDs) or other disorders in harmful and potentially life-threatening situations—making this an important safety issue for individuals affected and their families and caregivers. Children and adults with ASDs and other developmental disabilities are at higher risk of wandering off than are children and adults without these disorders or other cognitive disorders.

At the request of the Interagency Autism Coordinating CommitteeDescription: External Web Site Icon, a Safety SubcommitteeDescription: External Web Site Icon was convened to address wandering and other safety issues for children and adults with ASDs. CDC, as a member of the Subcommittee, submitted a proposal for the wandering code to the ICD-9-CM Coordination and Maintenance Committee for consideration at the March 2011 meeting, which represented the final opportunity for additions/revisions to the ICD-9-CM until 2014. As part of the Coordination and Maintenance Committee’s usual procedures, proposals were open for public comment for 4 weeks, and revisions Description: Adobe PDF file to the ICD-9-CM were announced online on June 10, taking effect October 1.

This code is intended to capture information about individuals, with any condition classified in the ICD, who wander. Wandering was deleted as a subcode under the Alzheimer’s and dementia code and added as a condition to be noted in association with disorders classified elsewhere [V40.31]. The intention is to provide a way to document, understand, and improve the situation for individuals who are at risk of injury or death due to dangerous wandering. Wandering should be coded if documented in the medical record by the provider (i.e., physician).

The wandering code is not linked to a specific diagnosis, nor is it part of the diagnostic codes used for autism or intellectual disabilities. The ICD-9-CM classifies behaviors and risk factors in addition to diseases and syndromes; as such, the wandering code is used in conjunction with other diagnostic and symptom or procedure codes.