Immune effector cell-associated neurotoxicity syndrome, grade 4
ICD-10 G92.04 is a billable code used to indicate a diagnosis of immune effector cell-associated neurotoxicity syndrome, grade 4.
Immune effector cell-associated neurotoxicity syndrome (ICANS) is a severe neurological complication that can occur following immunotherapy, particularly with CAR T-cell therapy. Grade 4 ICANS is characterized by life-threatening symptoms, including severe confusion, seizures, and significant neurological deficits. Patients may exhibit altered mental status, agitation, and may require intensive monitoring and intervention. The syndrome is thought to be related to the activation of immune effector cells that can lead to neuroinflammation and subsequent neurological dysfunction. Pain syndromes may manifest as headaches or neuropathic pain due to the underlying neurotoxicity. Autonomic disorders can also arise, presenting as dysautonomia, which may include symptoms like orthostatic hypotension or gastrointestinal dysmotility. Hydrocephalus may develop as a secondary complication due to increased intracranial pressure from edema or inflammation. The management of grade 4 ICANS often necessitates hospitalization, supportive care, and potentially the use of corticosteroids or other immunosuppressive therapies to mitigate the neurotoxic effects.
Thorough documentation of immunotherapy treatment, patient symptoms, and neurological assessments.
Patients receiving CAR T-cell therapy presenting with neurological symptoms.
Ensure clear documentation of the timeline of symptoms in relation to therapy.
Detailed neurological examination findings, imaging results, and treatment responses.
Patients with severe neurological deficits following immunotherapy.
Document any differential diagnoses considered and ruled out.
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.
Key symptoms include severe confusion, seizures, significant neurological deficits, and altered mental status, which require immediate medical attention.
