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v1.0.0
ICD-10 Guide
ICD-10 CodesD89.835

D89.835

Billable

Cytokine release syndrome, grade 5

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

Code Description

ICD-10 D89.835 is a billable code used to indicate a diagnosis of cytokine release syndrome, grade 5.

Key Diagnostic Point:

Cytokine release syndrome (CRS) is a severe systemic inflammatory response that can occur following certain therapies, particularly immunotherapies such as CAR T-cell therapy and monoclonal antibodies. Grade 5 CRS is characterized by life-threatening complications, including multi-organ failure, severe hypotension, and respiratory distress. Clinically, patients may present with high fever, tachycardia, hypotension, and altered mental status. The pathophysiology involves the overproduction of cytokines, leading to a cascade of inflammatory responses that can overwhelm the body's regulatory mechanisms. Management of grade 5 CRS typically requires intensive care support, including vasopressors, oxygen therapy, and potentially the use of immunosuppressive agents such as tocilizumab. Accurate coding of this condition is crucial for appropriate reimbursement and tracking of treatment outcomes, as it reflects the severity of the patient's condition and the complexity of care required.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires understanding of immunotherapy-related complications
  • Differentiation from other inflammatory conditions
  • Need for precise documentation of severity and management
  • Potential for multi-organ involvement complicating coding

Audit Risk Factors

  • Inadequate documentation of severity and treatment
  • Failure to capture all organ systems involved
  • Misclassification of CRS grade
  • Lack of supporting clinical evidence for the diagnosis

Specialty Focus

Medical Specialties

Hematology/Oncology

Documentation Requirements

Detailed clinical notes on patient history, treatment regimen, and response to therapy.

Common Clinical Scenarios

Patients receiving CAR T-cell therapy who develop severe CRS.

Billing Considerations

Ensure documentation reflects the severity of CRS and any multi-organ involvement.

Critical Care Medicine

Documentation Requirements

Comprehensive records of vital signs, interventions, and response to treatment.

Common Clinical Scenarios

Management of patients in the ICU with grade 5 CRS requiring intensive monitoring.

Billing Considerations

Document all supportive measures and their effectiveness in managing CRS.

Coding Guidelines

Inclusion Criteria

Use D89.835 When
  • Follow official ICD
  • CM guidelines for coding CRS, ensuring accurate documentation of the grade and associated complications
  • Include any relevant co
  • morbidities and treatments administered

Exclusion Criteria

Do NOT use D89.835 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

96413CPT Code

Chemotherapy administration, intravenous

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 the chemotherapy regimen.

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 ability to capture the severity and complexity of cases, which is essential for appropriate reimbursement and quality reporting.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like CRS, improving the ability to capture the severity and complexity of cases, which is essential for appropriate reimbursement and quality reporting.

Reimbursement & Billing Impact

reimbursement and quality reporting.

Resources

Clinical References

  • •
    Cytokine Release Syndrome: A Review

Coding & Billing References

  • •
    Cytokine Release Syndrome: A Review

Frequently Asked Questions

What are the key symptoms of grade 5 cytokine release syndrome?

Key symptoms include high fever, severe hypotension, respiratory distress, altered mental status, and multi-organ failure.

How is grade 5 CRS managed?

Management typically involves intensive care support, including vasopressors, oxygen therapy, and immunosuppressive agents like tocilizumab.