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ICD-10 Guide
ICD-10 CodesG92.9

G92.9

Billable

Unspecified toxic encephalopathy

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

Code Description

ICD-10 G92.9 is a billable code used to indicate a diagnosis of unspecified toxic encephalopathy.

Key Diagnostic Point:

Unspecified toxic encephalopathy refers to a neurological condition characterized by diffuse brain dysfunction resulting from exposure to toxic substances. This condition can manifest through a variety of symptoms, including cognitive impairment, altered consciousness, seizures, and motor dysfunction. The etiology of toxic encephalopathy can include exposure to heavy metals, solvents, drugs, or other environmental toxins. Patients may present with a range of neurological deficits, including pain syndromes, autonomic dysfunction, and hydrocephalus, which can complicate the clinical picture. Diagnosis typically involves a thorough history of exposure, neurological examination, and imaging studies to assess brain structure and function. Treatment focuses on removing the source of toxicity, supportive care, and rehabilitation to address neurological deficits. Given the broad range of potential toxins and the variability in patient response, the clinical management of toxic encephalopathy can be complex and requires a multidisciplinary approach.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential toxic agents leading to similar symptoms
  • Need for comprehensive patient history to identify exposure
  • Differential diagnosis with other neurological disorders
  • Potential for co-existing conditions complicating the clinical picture

Audit Risk Factors

  • Inadequate documentation of toxic exposure history
  • Failure to specify the type of toxin involved
  • Misclassification of symptoms as unrelated neurological disorders
  • Lack of supporting diagnostic tests in the medical record

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, history of toxin exposure, and results of imaging studies.

Common Clinical Scenarios

Patients presenting with cognitive decline, seizures, or unexplained neurological deficits following exposure to known toxins.

Billing Considerations

Ensure that all relevant diagnostic tests are documented to support the diagnosis of toxic encephalopathy.

Toxicology

Documentation Requirements

Comprehensive toxicological assessment, including laboratory results and exposure history.

Common Clinical Scenarios

Patients with acute or chronic exposure to environmental toxins presenting with neurological symptoms.

Billing Considerations

Collaboration with neurology for comprehensive management and documentation of the patient's condition.

Coding Guidelines

Inclusion Criteria

Use G92.9 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the patient's exposure history and clinical symptoms
  • Include any relevant laboratory or imaging results that support the diagnosis

Exclusion Criteria

Do NOT use G92.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

Used for follow-up visits to assess recovery from toxic encephalopathy.

Documentation Requirements

Document history of present illness, review of systems, and neurological examination findings.

Specialty Considerations

Neurologists should ensure comprehensive documentation of neurological status and any changes in symptoms.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of toxic encephalopathy, improving the ability to capture the complexity of the condition and its various causes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of toxic encephalopathy, improving the ability to capture the complexity of the condition and its various causes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of toxic encephalopathy, improving the ability to capture the complexity of the condition and its various causes.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What are the common causes of toxic encephalopathy?

Common causes include exposure to heavy metals, solvents, drugs, and environmental toxins. Each case may require specific diagnostic tests to identify the toxin involved.