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v1.0.0
ICD-10 Guide
ICD-10 CodesG92.02

G92.02

Billable

Immune effector cell-associated neurotoxicity syndrome, grade 2

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

Code Description

ICD-10 G92.02 is a billable code used to indicate a diagnosis of immune effector cell-associated neurotoxicity syndrome, grade 2.

Key Diagnostic Point:

Immune effector cell-associated neurotoxicity syndrome (ICANS) is a neurological complication that can occur following immunotherapy, particularly with CAR T-cell therapy. Grade 2 ICANS is characterized by moderate neurological symptoms that may include confusion, lethargy, and mild motor deficits. Patients may experience pain syndromes, such as headaches or neuropathic pain, as well as autonomic disorders that can manifest as fluctuations in heart rate and blood pressure. Hydrocephalus may also develop due to increased intracranial pressure, leading to further neurological impairment. The syndrome is a result of the immune system's response to the tumor and the therapy, which can lead to inflammation and neurotoxicity. Diagnosis is based on clinical evaluation and the exclusion of other causes of neurological symptoms. Management typically involves supportive care and may include corticosteroids to reduce inflammation. Understanding the nuances of ICANS is crucial for accurate coding and appropriate patient management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of immunotherapy-related complications
  • Differentiation from other neurological disorders
  • Assessment of symptom severity for grading
  • Documentation of neurological assessments

Audit Risk Factors

  • Inadequate documentation of symptom severity
  • Failure to specify the grade of ICANS
  • Misclassification of neurological symptoms
  • Lack of supporting clinical evidence for diagnosis

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed records of immunotherapy treatments, patient symptoms, and neurological evaluations.

Common Clinical Scenarios

Patients receiving CAR T-cell therapy presenting with neurological symptoms.

Billing Considerations

Close monitoring of neurological status and timely documentation of any changes.

Neurology

Documentation Requirements

Comprehensive neurological assessments and imaging studies to rule out other causes.

Common Clinical Scenarios

Patients with new-onset neurological symptoms post-immunotherapy.

Billing Considerations

Differentiating ICANS from other neurological disorders is critical for accurate coding.

Coding Guidelines

Inclusion Criteria

Use G92.02 When
  • Follow the official ICD
  • CM coding guidelines for reporting neurological disorders
  • Ensure accurate documentation of symptom severity and grading
  • Include any relevant comorbidities or complications in coding

Exclusion Criteria

Do NOT use G92.02 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

96413CPT Code

Chemotherapy administration, intravenous

Clinical Scenario

Used when administering CAR T-cell therapy.

Documentation Requirements

Document the type of therapy, dosage, and patient response.

Specialty Considerations

Oncology specialists must ensure accurate coding of therapy related to ICANS.

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 ICANS, improving the accuracy of patient records and facilitating better management of complications arising from immunotherapy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like ICANS, improving the accuracy of patient records and facilitating better management of complications arising from immunotherapy.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like ICANS, improving the accuracy of patient records and facilitating better management of complications arising from immunotherapy.

Resources

Clinical References

  • •
    American Society of Clinical Oncology (ASCO)

Coding & Billing References

  • •
    American Society of Clinical Oncology (ASCO)

Frequently Asked Questions

What are the common symptoms of grade 2 ICANS?

Common symptoms include confusion, lethargy, mild motor deficits, and autonomic instability. Patients may also experience headaches and other pain syndromes.