Immune effector cell-associated neurotoxicity syndrome, grade 5
ICD-10 G92.05 is a billable code used to indicate a diagnosis of immune effector cell-associated neurotoxicity syndrome, grade 5.
Immune effector cell-associated neurotoxicity syndrome (ICANS) is a severe neurological complication that can occur following immunotherapy, particularly with CAR T-cell therapy. Grade 5 ICANS represents the most severe form of this syndrome, characterized by life-threatening neurological symptoms such as seizures, altered mental status, and significant autonomic dysfunction. Patients may experience severe pain syndromes, including neuropathic pain, due to the neurotoxic effects of the immune effector cells. Autonomic disorders may manifest as dysautonomia, leading to symptoms such as orthostatic hypotension, tachycardia, and gastrointestinal dysmotility. Hydrocephalus may also develop as a result of increased intracranial pressure due to cerebral edema. The clinical presentation can vary widely, and timely recognition and management are crucial to prevent long-term neurological deficits or death. The grading system for ICANS helps clinicians assess the severity of symptoms and guide treatment decisions, with grade 5 indicating the highest level of severity and necessitating immediate intervention.
Detailed records of immunotherapy treatment, neurological assessments, and symptom management.
Patients receiving CAR T-cell therapy who develop neurological symptoms post-treatment.
Ensure documentation reflects the timeline of symptom onset relative to therapy.
Comprehensive neurological evaluations, including mental status exams and autonomic function tests.
Patients presenting with severe neurological deficits following immunotherapy.
Document all neurological assessments and interventions to support coding.
Used when a patient with G92.05 is admitted for severe neurological symptoms.
Detailed history, examination, and medical decision-making must be documented.
Oncology and neurology specialists should collaborate on documentation.
Grade 5 ICANS is characterized by life-threatening neurological symptoms, including severe seizures, altered mental status, and significant autonomic dysfunction.
