1. Disturbance of consciousness (i.e., reduced clarity of awareness of the environment) with reduced ability to focus, sustain, or shift attention.
2. A change in cognition (such as memory deficit, disorientation, language disturbance) or the development of a perceptual disturbance that is not better accounted for by a preexisting, established, or evolving dementia.
3. The disturbance develops over a short period of time (usually hours to days) and tends to fluctuate during the course of the day.
4. There is evidence from the history, physical examination, or laboratory findings that the disturbance is caused by the direct physiological consequences of a general medical condition.

Coding note: If delirium is superimposed on a preexisting vascular dementia, indicate the delirium by coding vascular dementia, with delirium.
Coding note: Include the name of the general medical condition on Axis I, e.g., Delirium due to hepatic encephalopathy; also code the general medical condition on Axis III.