Cytokine release syndrome, grade 4
ICD-10 D89.834 is a billable code used to indicate a diagnosis of cytokine release syndrome, grade 4.
Cytokine release syndrome (CRS) is a severe systemic inflammatory response that can occur following certain therapies, particularly immunotherapies such as CAR T-cell therapy or monoclonal antibodies. Grade 4 CRS is characterized by life-threatening symptoms, including severe hypotension, hypoxia, and multi-organ dysfunction. Patients may present with high fever, tachycardia, and significant laboratory abnormalities such as elevated inflammatory markers (e.g., ferritin, C-reactive protein) and cytopenias. The pathophysiology involves the excessive release of pro-inflammatory cytokines, leading to a cascade of immune activation and systemic inflammation. Management typically requires immediate medical intervention, including supportive care, corticosteroids, and possibly other immunosuppressive agents. The severity of CRS is graded based on clinical criteria, with grade 4 indicating the highest level of severity and risk of mortality. Accurate coding of this condition is crucial for appropriate treatment reimbursement and tracking of adverse events associated with immunotherapy.
Detailed clinical notes on patient presentation, treatment history, and response to therapy.
Patients undergoing CAR T-cell therapy experiencing severe CRS.
Ensure documentation reflects the severity of symptoms and any interventions taken.
Comprehensive records of vital signs, organ function, and treatment interventions.
Management of patients in ICU with severe CRS requiring intensive monitoring.
Accurate recording of multi-organ dysfunction and response to treatment is essential.
Used when administering chemotherapy that may lead to CRS.
Document the drug administered, dosage, and patient response.
Oncology specialists should ensure accurate coding of chemotherapy-related complications.
Grade 4 CRS is characterized by severe hypotension, hypoxia, high fever, tachycardia, and multi-organ dysfunction. Patients may require intensive monitoring and intervention.
CRS is graded based on clinical criteria established by the American Society for Transplantation and Cellular Therapy, with grade 4 indicating life-threatening symptoms requiring urgent medical intervention.
