Encephalopathy (acute) G93.40 ICD-10-CM Diagnosis Code G93.40 ICD-10-CM Diagnosis Code G93.41 ICD-10-CM Diagnosis Code G93.49 ICD-10-CM Diagnosis Code G04.90 ICD-10-CM Diagnosis Code G04.91 Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.
Ref: “ ICD-10-CM Official Guidelines for Coding and Reporting,” Section I.A.10. Therefore, G92 Toxic encephalopathy is the correct code to report for the diagnosis “toxic metabolic encephalopathy” even though the term “metabolic” is not in the description for code G92.
Diagnosis Index entries containing back-references to G92: Bromidism, bromism G92 Encephalitis (chronic) (hemorrhagic) (idiopathic) (nonepidemic) (spurious) (subacute) G04.90 ICD-10-CM Diagnosis Code G04.90 Encephalopathy (acute) G93.40 ICD-10-CM Diagnosis Code G93.40 Jamaican neuropathy G92
The hospital disagreed with the external auditor/payer’s contention that a “T code” for a drug or toxin must always precede code G92 when coding and reporting the diagnosis “toxic metabolic encephalopathy.” Code G92 Toxic Encephalopathy is a Major Complication and Comorbidity (MCC) code.
G92.88 - Other toxic encephalopathy is a sample topic from the ICD-10-CM. To view other topics, please log in or purchase a subscription. ICD-10-CM 2022 Coding Guide™ from Unbound Medicine.
If you search for toxic encephalopathy, there is the subcategory for metabolic encephalopathy, and both have the code G92. If you look for metabolic encephalopathy, it has the code G93. 41 with the subcategories of drug induced and toxic, both with G92 codes.
Code G92 Toxic Encephalopathy is a Major Complication and Comorbidity (MCC) code. MCC codes have the potential of affecting MS-DRG assignment and reimbursement.
The term "toxic encephalopathy" is used to indicate brain dysfunction caused by toxic exposure [4]. Toxic encephalopathy includes a spectrum of symptomatology ranging from subclinical deficits to overt clinical disorders.
Acute toxic-metabolic encephalopathy (TME) is a condition of acute global cerebral dysfunction manifested by altered consciousness, behavior changes, and/or seizures in the absence of primary structural brain disease or direct central nervous system (CNS) infection.
When encephalopathy is the principal diagnosis, the UTI can be added as a CC. When the encephalopathy is a principal diagnosis, auditor denials are not the issue; the real concern is with the documentation not supporting it as a reportable condition.
Toxic encephalopathy describes acute mental status alteration due to medications, illicit drugs, or toxic chemicals. Metabolic encephalopathy is caused by any of a large number of metabolic disturbances.
Toxic encephalopathy is a neurologic disorder caused by exposure to neurotoxic organic solvents such as toluene, following exposure to heavy metals such as manganese, as a side effect of melarsoprol treatment for African trypanosomiasis, adverse effects to prescription drugs, or exposure to extreme concentrations of ...
Many drugs may cause toxic encephalopathy....Toxic encephalopathy.Type of therapeutic agentDrugsAntineoplastic agentsMethotrexate (± seizures, leukotoxic damage)IfosfamidePaclitaxel (± seizures)Cisplatin (± seizures, leukotoxic damage)32 more rows
Is this covered by the ADA and what accommodations are reasonable? Yes, this is covered.
The following are some major types of encephalopathy, along with their causes.Chronic traumatic encephalopathy. ... Glycine encephalopathy. ... Hashimoto's encephalopathy. ... Hepatic encephalopathy. ... Hypertensive encephalopathy. ... Hypoxic ischemic encephalopathy. ... Toxic-metabolic encephalopathy. ... Infectious encephalopathies.More items...
The symptoms of toxic encephalopathy can be debilitating and often totally disabling, making it difficult, if not impossible, for patients to hold a job and maintain their normal way of life.
In this blog we are focusing on the coding and reporting of the diagnosis “toxic metabolic encephalopathy,” specifically on the instructions, inclusion terms and Excludes 1 note in the Tabular section, codes G92 Toxic Encephalopathy, and G93.41 Metabolic encephalopathy. These codes are in Chapter 6. Diseases of the Nervous System.
If applicable, the query response should specify the drug or toxic agent that caused the TME, in which case a “T” code from T36-T50 or T51-T65 is reported first, followed by G92. If the query response is that the etiology of the TME was not a drug or toxic agent, no “T” code is reported and G92 only is reported for TME.
Code G92 Toxic Encephalopathy is a Major Complication and Comorbidity (MCC) code. MCC codes have the potential of affecting MS-DRG assignment and reimbursement. When MCCs are reported as a secondary diagnosis code, the facility may receive higher reimbursement from a payer than if the MCC code were not present. For this reason, the presence of an MCC code is often targeted and challenged by payers. This is not to imply that the payer’s challenge is meritless or their sole motivation is to reimburse the hospital less.
Therefore, G92 Toxic encephalopathy is the correct code to report for the diagnosis “toxic metabolic encephalopathy” even though the term “metabolic” is not in the description for code G92.
The National Institute of Neurological Disorders and Stroke defines “encephalopathy” as follows: “Encephalopathy is a term for any diffuse disease of the brain that alters brain function or structure.
Terms defined: “Encephalopathy” can be broadly defined as a global brain dysfunction (brain damage, brain malfunction or brain disease) manifested by an altered mental state that is not due to an underlying neurodegenerative state. The National Institute of Neurological Disorders and Stroke defines “encephalopathy” as follows:
After this facility had responded to the payer’s challenge by stating why the diagnosis TME met clinical criteria and was accurately coded as G92 Toxic Encephalopathy, the payer agreed that the diagnosis TME was valid but still maintained that the TME was incorrectly coded as G92 Toxic Encephalopathy alone, with no “T” code (for a drug or toxin) preceding it.
349.82 is a legacy non-billable code used to specify a medical diagnosis of toxic encephalopathy. This code was replaced on September 30, 2015 by its ICD-10 equivalent.
References found for the code 349.82 in the Index of Diseases and Injuries:
The brain, spinal cord, and nerves make up the nervous system. Together they control all the workings of the body. When something goes wrong with a part of your nervous system, you can have trouble moving, speaking, swallowing, breathing, or learning. You can also have problems with your memory, senses, or mood.
General Equivalence Map Definitions The ICD-9 and ICD-10 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.
Static encephalopathy. Clinical Information. A disorder characterized by a pathologic process involving the brain. A disorder of the brain that can be caused by disease, injury, drugs, or chemicals.
The 2022 edition of ICD-10-CM G93.40 became effective on October 1, 2021.