Immune effector cell-associated neurotoxicity syndrome, grade 3
ICD-10 G92.03 is a billable code used to indicate a diagnosis of immune effector cell-associated neurotoxicity syndrome, grade 3.
Immune effector cell-associated neurotoxicity syndrome (ICANS) is a serious neurological complication that can occur following immunotherapy, particularly with CAR T-cell therapy. Grade 3 ICANS is characterized by severe neurological symptoms that significantly impair daily functioning. Patients may experience confusion, disorientation, agitation, and severe headaches, which can be indicative of increased intracranial pressure or hydrocephalus. Autonomic dysfunction may manifest as fluctuations in heart rate and blood pressure, and patients may also report pain syndromes, including neuropathic pain. The pathophysiology of ICANS involves the activation of immune effector cells that can lead to neuroinflammation and neuronal damage. Diagnosis is based on clinical assessment, neurological examination, and exclusion of other causes of neurological symptoms. Management typically involves supportive care, corticosteroids, and monitoring for complications such as seizures or hydrocephalus.
Detailed records of immunotherapy treatment, patient symptoms, and neurological assessments.
Patients receiving CAR T-cell therapy who develop neurological symptoms post-treatment.
Close monitoring for neurological changes and timely documentation of symptom progression.
Comprehensive neurological evaluations, including cognitive assessments and autonomic function tests.
Patients presenting with confusion, agitation, or severe headaches following immunotherapy.
Differentiating ICANS from other neurological disorders and documenting the severity of symptoms.
Used for inpatient evaluation of severe neurological symptoms.
Detailed history, examination, and medical decision-making.
Oncology and neurology must collaborate for comprehensive care.
Grade 3 ICANS is characterized by severe confusion, agitation, significant headaches, and autonomic instability, which can severely impact daily functioning.
