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2025 ICD-10-CM code G92.8

Other toxic encephalopathy. This encompasses toxic encephalopathy not elsewhere classified, including toxic metabolic encephalopathy.

Code first any underlying condition, such as liver disease, if present.Do not use G92.8 for encephalopathy due to drug or chemical poisoning; use the appropriate codes from T36-T65 instead. If the encephalopathy is due to an adverse effect of a drug, use T36-T50.

Medical necessity for this code is established by the presence of encephalopathy due to a toxic cause (other than drugs or chemicals) impacting the patient's cognitive function or neurological status. Documentation should support the diagnosis and the need for medical intervention.

The clinician is responsible for determining the underlying cause of the encephalopathy and documenting it clearly in the patient's record, along with any associated conditions or symptoms. This includes specifying the toxic substance (if known) or indicating the presence of hepatic encephalopathy or other contributing factors.

IMPORTANT:If due to hepatic encephalopathy, also use K72.90. For drug or chemical poisoning, see T36-T65. For adverse effects of drugs, see T36-T50.

In simple words: This code refers to a brain problem caused by exposure to a harmful substance, but not specifically drugs or chemicals.If the problem is related to liver failure, another code will be used alongside this one. If it is due to a drug or chemical, a different code for poisoning will also be necessary.

Other toxic encephalopathy. This code is used for toxic encephalopathy that is not due to drugs or chemicals.If the toxic encephalopathy is due to hepatic encephalopathy (liver failure), assign code K72.90 in addition to G92.8. Code first any underlying poisoning due to drug or toxin, if applicable (T36-T65 with fifth or sixth character 1-4). Use an additional code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5).

Example 1: A patient presents with altered mental status, confusion, and tremors. After a thorough evaluation, it is determined that these symptoms are due to exposure to heavy metals, but not drug-induced, leading to the diagnosis of toxic encephalopathy., A patient with a history of liver disease develops hepatic encephalopathy, resulting in altered mental status and confusion. Along with the code for the liver disease,K72.90,G92.8 would also apply., A patient undergoing chemotherapy experiences changes in their cognitive function, including difficulty concentrating and memory problems, consistent with a diagnosis of toxic encephalopathy, a side-effect of the treatment. But if any specific drug is responsible, the code for that would be a better option instead of G92.8.

Documentation should clearly specify the type of encephalopathy, its underlying cause, and the patient's clinical presentation, including any neurological or cognitive deficits. If the encephalopathy is due to a toxic substance, the substance should be identified if known. If related to another condition like liver disease, this should also be documented.

** For cases where the encephalopathy is unspecified, code G92.9 is appropriate.

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