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2025 ICD-10-CM code G92.9

Unspecified toxic encephalopathy. Code first poisoning due to drug or toxin, if applicable.

Code first any associated poisoning due to drug or toxin (T36-T65); Use additional code for adverse effect, if applicable, to identify drug (T36-T50).

Medical necessity is established by the presence of encephalopathy, supported by clinical documentation, and a reasonable suspicion of a toxic cause based on available evidence or patient history.

IMPORTANT:Consider additional coding for adverse effects (T36-T50) and/or poisoning due to drug/toxin (T36-T65) if applicable.

In simple words: A condition where brain function is affected by exposure to a harmful substance, but the specific cause isn't identified.

Unspecified toxic encephalopathy. Code first any associated poisoning due to drug or toxin (T36-T65 with fifth or sixth character 1-4). Use 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 after accidental exposure to an unknown chemical. After initial testing, no specific toxin is identified. G92.9 is used to code the toxic encephalopathy., A patient with a history of polysubstance abuse is admitted with confusion and disorientation. Laboratory tests are inconclusive for a specific drug. G92.9 is used to describe the encephalopathy as the specific toxic cause remains undetermined., An individual is brought to the emergency room after being found unresponsive in a poorly ventilated area with a strong, unusual odor. While carbon monoxide poisoning is suspected, initial tests are negative. The physician uses G92.9 to code the encephalopathy pending further investigation.

Clinical findings of altered mental status; Evidence of toxic exposure, even if the specific substance is unknown; Ruling out of other causes of encephalopathy.

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