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v1.0.0
ICD-10 Guide
ICD-10 CodesD89.832

D89.832

Billable

Cytokine release syndrome, grade 2

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 D89.832 is a billable code used to indicate a diagnosis of cytokine release syndrome, grade 2.

Key Diagnostic Point:

Cytokine release syndrome (CRS) is a systemic inflammatory response that can occur following certain therapies, particularly immunotherapies such as CAR T-cell therapy or monoclonal antibodies. Grade 2 CRS is characterized by moderate symptoms that may include fever, fatigue, headache, myalgia, and mild hypotension. Patients may exhibit laboratory abnormalities such as elevated inflammatory markers (e.g., C-reactive protein, ferritin) and changes in blood cell counts. The syndrome results from the rapid release of cytokines into the bloodstream, leading to a cascade of inflammatory responses. In grade 2 CRS, symptoms are more pronounced than in grade 1 but do not require intensive medical intervention. Management typically involves supportive care, monitoring, and may include the use of corticosteroids or other immunosuppressive agents to mitigate symptoms. Understanding the grading of CRS is crucial for appropriate coding and treatment planning, as it impacts clinical decision-making and resource allocation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of immunotherapy-related complications
  • Differentiation from other inflammatory conditions
  • Need for accurate grading of severity
  • Potential overlap with other hematologic disorders

Audit Risk Factors

  • Inadequate documentation of symptoms and severity
  • Failure to specify the grade of CRS
  • Misclassification of CRS with other inflammatory syndromes
  • Lack of supporting lab results

Specialty Focus

Medical Specialties

Hematology/Oncology

Documentation Requirements

Detailed clinical notes on patient symptoms, treatment history, and laboratory results.

Common Clinical Scenarios

Patients receiving CAR T-cell therapy or monoclonal antibodies experiencing CRS.

Billing Considerations

Ensure clear documentation of CRS grading and management strategies.

Immunology

Documentation Requirements

Comprehensive records of immune response assessments and cytokine levels.

Common Clinical Scenarios

Patients with autoimmune disorders undergoing treatment that may trigger CRS.

Billing Considerations

Document any pre-existing conditions that may influence CRS presentation.

Coding Guidelines

Inclusion Criteria

Use D89.832 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the condition's severity and associated symptoms
  • Include relevant lab results to support the diagnosis

Exclusion Criteria

Do NOT use D89.832 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

96413CPT Code

Chemotherapy administration, intravenous, push technique

Clinical Scenario

Used when administering chemotherapy that may lead to CRS.

Documentation Requirements

Document the drug administered, dosage, and patient response.

Specialty Considerations

Oncology specialists should ensure accurate coding of chemotherapy-related complications.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like CRS, improving the accuracy of patient records and facilitating better tracking of treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like CRS, improving the accuracy of patient records and facilitating better tracking of treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like CRS, improving the accuracy of patient records and facilitating better tracking of treatment outcomes.

Resources

Clinical References

  • •
    Cytokine Release Syndrome: A Comprehensive Review

Coding & Billing References

  • •
    Cytokine Release Syndrome: A Comprehensive Review

Frequently Asked Questions

What are the key symptoms of grade 2 cytokine release syndrome?

Grade 2 CRS typically presents with moderate symptoms such as fever, fatigue, headache, myalgia, and mild hypotension, along with laboratory abnormalities like elevated inflammatory markers.