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2025 ICD-10-CM code G92

Toxic encephalopathy. Brain dysfunction caused by exposure to drugs or other toxic agents.

Code the drug or toxic agent that caused the encephalopathy first, if applicable. Use additional codes to identify the specific substance (T36-T65).

Medical necessity for treatment of toxic encephalopathy is established by the presence of signs and symptoms of brain dysfunction, along with evidence of exposure to a toxic substance. The specific treatment provided should be appropriate for the type of toxin and the severity of the patient's condition.

Providers diagnose the condition based on medical history, signs, symptoms, physical and neurological examination. They also utilize diagnostic studies including blood tests, imaging (CT, MRI, FDG-PET, SPECT), and electrodiagnostic studies (sensory-evoked potentials and EEG). Treatment is based on the cause and involves removing the toxin, counteracting medications, nutritional supplements, supportive care, and possibly anticonvulsants.

In simple words: Toxic encephalopathy is a condition where the brain doesn't function properly due to exposure to harmful substances like drugs, chemicals, or heavy metals.The severity of symptoms, which can range from trouble concentrating to seizures and coma, depends on the amount and length of exposure to the toxin.

Toxic encephalopathy, also known as toxic encephalitis or toxic metabolic encephalopathy, is damage, inflammation, or dysfunction of the brain caused by exposure to toxins such as pharmacologic or illicit drugs, chemicals and solvents, heavy metals, or other noxious substances. Exposure to industrial or occupational toxins is a common cause. Symptoms vary in severity depending on the level and duration of exposure and usually subside after the toxin is eliminated from the body.Symptoms may include difficulty concentrating, impaired consciousness, seizures, symmetrical muscle weakness, sensory disturbances, difficulty speaking or swallowing, loss of coordination (ataxia), tremor, slow movements (bradykinesia), and behavioral and psychological changes. Prolonged heavy exposure can result in irreversible symptoms, coma, and even death.Diagnosis is based on medical history, signs and symptoms, and physical and neurological examination. Diagnostic studies include blood tests to detect toxins or chemical imbalance. Imaging studies include CT, MRI, FDGPET, and SPECT scans, and electrodiagnostic studies include sensory–evoked potentials and EEG. Treatment depends on the cause and includes eliminating the toxin (such as chelation for heavy metals), medications to counteract the toxin or slow the progression of the damage, nutritional supplements, supportive care, and anticonvulsants if the patient is having seizures.

Example 1: A patient presents with seizures, confusion, and muscle weakness after accidental exposure to a pesticide. Blood tests confirm the presence of the pesticide, and the diagnosis of toxic encephalopathy is made., A patient with a history of drug abuse is admitted to the hospital with altered mental status, tremors, and difficulty speaking.Toxic encephalopathy is suspected, and further investigation reveals the presence of a specific drug in the patient's system., A factory worker develops gradual cognitive impairment, memory loss, and personality changes after prolonged exposure to heavy metals in the workplace.Neurological examination and imaging studies support the diagnosis of toxic encephalopathy due to heavy metal poisoning.

Documentation should include the type of toxic encephalopathy, evidence of exposure to the toxic agent (e.g., laboratory results, occupational history), detailed neurological examination findings, and the results of any diagnostic studies performed (e.g., blood tests, imaging, EEG).

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