Immune effector cell-associated neurotoxicity syndrome
ICD-10 G92.0 is a billable code used to indicate a diagnosis of immune effector cell-associated neurotoxicity syndrome.
Immune effector cell-associated neurotoxicity syndrome (ICANS) is a neurological complication that can occur following immunotherapy, particularly with CAR T-cell therapy. This syndrome is characterized by a range of neurological symptoms, including confusion, agitation, seizures, and altered mental status. Patients may also experience autonomic dysfunction, which can manifest as changes in heart rate, blood pressure, and temperature regulation. Pain syndromes may arise due to neuroinflammation or direct effects on the nervous system, leading to neuropathic pain or headaches. Hydrocephalus may develop as a secondary complication due to increased intracranial pressure from edema or inflammation. The pathophysiology of ICANS involves the activation of immune effector cells that can cross the blood-brain barrier, leading to neuroinflammation and neuronal damage. Diagnosis is primarily clinical, supported by imaging studies and laboratory tests to rule out other causes of neurological symptoms. Management typically involves supportive care, corticosteroids, and symptomatic treatment.
Detailed records of immunotherapy treatments, including type, dosage, and administration dates.
Patients presenting with neurological symptoms post-CAR T-cell therapy.
Close monitoring of neurological status and timely documentation of changes.
Comprehensive neurological assessments and imaging results.
Evaluation of patients with acute neurological changes following immunotherapy.
Differentiating ICANS from other neurological conditions such as infections or metabolic disturbances.
Used when administering CAR T-cell therapy.
Document the type of therapy, dosage, and patient response.
Oncology specialists must ensure accurate coding of the therapy administered.
Common symptoms include confusion, agitation, seizures, headaches, and autonomic dysfunction such as changes in heart rate and blood pressure.
Diagnosis is primarily clinical, based on the presence of neurological symptoms following immunotherapy, with imaging and laboratory tests to rule out other causes.
