Immune effector cell-associated neurotoxicity syndrome, grade unspecified
ICD-10 G92.00 is a billable code used to indicate a diagnosis of immune effector cell-associated neurotoxicity syndrome, grade unspecified.
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. The pathophysiology of ICANS is believed to involve the activation of immune effector cells that can lead to neuroinflammation and subsequent neuronal dysfunction. Patients may experience autonomic dysregulation, which can manifest as changes in heart rate, blood pressure, and temperature regulation. Hydrocephalus may also develop as a secondary complication due to increased intracranial pressure. Pain syndromes can arise from nerve irritation or damage, contributing to the overall symptomatology. The severity of ICANS can vary, and when unspecified, it indicates that the clinician has not graded the severity of the syndrome, which can complicate treatment and management strategies.
Detailed records of immunotherapy treatment, patient response, and neurological assessments.
Patients undergoing CAR T-cell therapy presenting with neurological symptoms.
Close monitoring of neurological status and timely documentation of any changes.
Comprehensive neurological evaluations, including mental status exams and autonomic function tests.
Patients with ICANS presenting with seizures or altered mental status.
Differentiating ICANS from other neurological disorders and documenting the timeline of symptom onset.
Used when administering CAR T-cell therapy in an outpatient setting.
Document the drug administered, dosage, and patient response.
Oncology specialists should ensure accurate coding of the therapy type.
Common symptoms include confusion, agitation, seizures, headache, and autonomic dysregulation such as changes in heart rate and blood pressure.
Diagnosis is based on the presence of neurological symptoms following immunotherapy, with exclusion of other potential causes.
