what is the correct icd 10 code for metabolic encephalopathy

by Prof. Deja White 9 min read

ICD-10 code G93. 41 for Metabolic encephalopathy is a medical classification as listed by WHO under the range - Diseases of the nervous system .

How to code uremic encephalopathy?

What Are The Causes Of Uremic Encephalopathy?

  • Hypertension
  • Diabetes mellitus (both type 1 & 2)
  • polycystic kidney disease
  • Glomerulitis ( inflammation of the glomeruli of the kidneys)
  • Recurrent kidneys infection
  • Kidney stones that may cause obstruction at any site of the urinary tract
  • Prostate enlarged
  • Cancers
  • Patient having high uric acid in blood

When to query for encephalopathy?

Encephalopathy is a general term and means brain disease, brain damage or malfunction. Physicians often use encephalopathy and altered mental status interchangeably. When coders see this documentation in the healthcare records, they typically need to query the physician for clarification of the diagnosis.

What to know about encephalopathy?

What to know about encephalopathy

  • Causes and types of encephalopathy. Encephalopathy is when the brain changes due to damage, disease, or a disorder. ...
  • Encephalopathy vs. encephalitis. ...
  • Symptoms of encephalopathy. Fatigue, difficulty concentrating, and forgetfulness are potential symptoms of encephalopathy. ...
  • Diagnosis. ...
  • Treatments. ...
  • Complications. ...
  • Prevention. ...
  • Outlook. ...

What are the four stages of hepatic encephalopathy?

What are the four stages of hepatic encephalopathy? Stage 1: mild symptoms, such as loss of sleep and shortened attention span. Stage 2: moderate symptoms, such as memory loss and slurred speech. Stage 3: severe symptoms, including personality changes, confusion, and extreme lethargy. Stage 4: a loss of consciousness and coma.

How do you code metabolic encephalopathy?

Whenever “metabolic encephalopathy” is documented, code G93. 41, Metabolic encephalopathy, should be assigned.

Can metabolic encephalopathy be coded as principal diagnosis?

The admission is five days long and the final diagnosis is encephalopathy due to polypharmacy with a metabolic component due to UTI. If toxic encephalopathy (encephalopathy due to drug) is sequenced as the principal diagnosis, metabolic encephalopathy as a secondary diagnosis will act as an MCC.

What is acute metabolic encephalopathy?

Acute toxic-metabolic encephalopathy (TME), which encompasses delirium and the acute confusional state, is an acute condition of global cerebral dysfunction in the absence of primary structural brain disease [1].

Can Toxic and metabolic encephalopathy be coded together?

If you look for metabolic encephalopathy, it has the code G93. 41 with the subcategories of drug induced and toxic, both with G92 codes. On the other hand, it can also be looked at as yes, you can code both. Again, from the Official Guidelines, code G93.

What can cause metabolic encephalopathy?

Metabolic encephalopathy. This happens when another health condition, such as diabetes, liver disease, kidney failure, or heart failure, makes it hard for the brain to work. For example, if blood sugar gets too high in diabetes, it can lead to confusion and even a coma.

Can CVA cause metabolic encephalopathy?

Encephalopathy is not considered inherent in acute cerebrovascular accident/stroke and should be reported as an additional diagnosis when documented and supported. Encephalopathy due to sepsis/septic should be reported as metabolic (see ICD-10-CM Index)

Is metabolic encephalopathy the same as hepatic encephalopathy?

Hepatic encephalopathy: This happens if liver disease causes toxins to build up in a person's blood. Toxic metabolic encephalopathy: This occurs when toxic chemicals, or a chemical imbalance caused by an infection, affects brain function.

What are types of metabolic encephalopathy?

There are two major types of metabolic encephalopathies, namely those due to lack of glucose, oxygen or metabolic cofactors (which are usually vitamin-derived) and those due to peripheral organ dysfunction (Table 38-1).

Is metabolic encephalopathy the same as dementia?

Toxic‐metabolic encephalopathy can be distinguished from dementia primarily by the patient's level of consciousness acutely deteriorating and subsequently fluctuating. For example, dementia takes at least 6 months or longer to appear in the most rapidly developing illnesses, such as Creutzfeldt‐Jakob disease.

What is the difference between toxic and metabolic encephalopathy?

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-metabolic encephalopathy describes a combination of toxic and metabolic factors.

What is toxic encephalopathy as principal diagnosis?

“Toxic metabolic encephalopathy” is a combination of toxic and metabolic factors, a result of infections, the presence of toxins, or organ failure.

Can you code encephalopathy and delirium?

Acute encephalopathy and delirium are clinically similar, but for coding purposes, very different. Delirium is a low-weighted symptom; encephalopathy is a serious, high-weighted medical condition. Delirium is usually due to an underlying encephalopathy, and clinicians should document as such if clinically present.

Can you code encephalopathy with seizures?

“ANSWER: Encephalopathy due to postictal state is not coded separately since it is integral to the condition... The postictal state is a transient deficit, occurring between the end of an epileptic seizure and the patient's return to baseline.

What is the G92 code?

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.

What is TME in medical terminology?

Coding “toxic metabolic encephalopathy” (TME) Because the term “encephalopathy” is very broad, it is normally preceded in documentation by various terms that describe the reason, cause, or special conditions of the patient that led to the brain malfunction.

What is the T code for TME?

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.

What happens when the body's electrolytes are off balance?

When the electrolytes, hormones, or other chemicals in the body are off their normal balance, or there is the presence of an infection or toxic chemical, the brain’s function can be affected . The encephalopathy usually resolves when the underlying chemical imbalance is restored or offending infection/toxin removed.

What is the code for toxic encephalopathy?

A code from T36-T50 or a code from T51-T65 is not required and sequenced first, ...

Is T36 T50 required for T51 T65?

A code from T36-T50 or a code from T51-T65 is not required and sequenced first, before G92 Toxic encephalopathy unless a drug or toxic agent is applicable to the case and documented as the etiology of the TME. NJPR blogs are for educational purposes and are accurate at the time of publishing. Learn more.

What is the term for any diffuse disease of the brain that alters brain function or structure?

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.