Encephalopathy ICD-10-CM Codes | 2023
Discover the commonly used ICD-10 codes for Encephalopathy, their clinical relevance, and implications in medical billing.
Fact Checked by Ericka Pingol.
What ICD-10 Codes are Used for Encephalopathy?
Encephalopathy is a term that means brain disease, damage, or malfunction. In modern usage, encephalopathy does not refer to a single disease but a syndrome of overall brain dysfunction. This syndrome can have many different organic and inorganic causes. Here are some of the commonly used ICD-10 codes for Encephalopathy:
- G93.40 - Encephalopathy, unspecified: This code is used when the type of Encephalopathy is not specified in the medical records. This falls under the "Other disorders of the nervous system."
- G93.49 - Other Encephalopathy: This code is used when the patient's condition doesn't match any specific types of Encephalopathy. It's used when the documentation supports the patient has Encephalopathy, but it differs from the types described in other categories.
- K76.82 - Hepatic Encephalopathy: Hepatic encephalopathy is a worsening of brain function that occurs when the liver can no longer remove toxic substances in the blood. This code took effect on October 1, 2022.
- G92 - Toxic Encephalopathy: This code is for Encephalopathy caused by exposure to harmful substances. It often results from exposure to drugs or toxins.
- G31.83 - Metabolic Encephalopathy: This code is used to classify Encephalopathy resulting from metabolic issues, such as electrolyte imbalances, organ failure, or endocrine dysfunctions.
- G31.2 - Degenerative Dementia, Not Elsewhere Classified: This code is used when the patient's dementia is due to brain damage or disease, not Alzheimer's or other specific degenerative diseases.
- F05 - Delirium Due to Known Physiological Condition: This code is used when delirium results from a known physiological condition, which could be any medical condition other than a mental disorder.
You can watch this explainer video to understand more about these codes, their usage, and their importance in the medical billing and coding process.
Which Encephalopathy ICD codes are Billable?
Here are the commonly used ICD-10 codes for Encephalopathy and whether they are billable or not:
- G93.40 - Encephalopathy, unspecified: Yes, this code is billable.
- G93.49 - Other Encephalopathy: Yes, this code is billable.
- K76.82 - Hepatic Encephalopathy: Yes, this code is billable.
- G92 - Toxic Encephalopathy: Yes, this code is billable.
- G31.83 - Metabolic Encephalopathy: Yes, this code is billable.
- G31.2 - Degenerative Dementia, Not Elsewhere Classified: Yes, this code is billable.
- F05 - Delirium Due to Known Physiological Condition: Yes, this code is billable.
Clinical Information
- Encephalopathy is a general term describing a disease that affects the function or structure of the brain.
- It is characterized by altered mental state that can manifest as confusion, disorientation, behavioral changes, and impaired cognitive function.
- The causes of encephalopathy can be numerous and varied. They include infections, organ failure (such as liver or kidney failure), lack of oxygen, exposure to toxins, and certain metabolic diseases.
- Hepatic encephalopathy, represented by ICD code K76.82, is a specific type caused by liver disease. The liver's inability to remove toxins from the blood leads to their buildup in the brain, resulting in cognitive impairment and neurological symptoms.
- Metabolic encephalopathy (G31.83) occurs when metabolic issues, like electrolyte imbalances or organ failure, lead to brain dysfunction.
- Toxic encephalopathy (G92) results from drug exposure or other harmful substances.
- Symptoms of encephalopathy can range from mild, such as slight memory loss or subtle personality changes, to severe, including seizures, loss of consciousness, or even coma.
- Treatment for encephalopathy focuses on addressing the underlying cause. This could involve medication to treat an infection, dialysis for kidney failure, or lifestyle changes for hepatic encephalopathy.
- Even with treatment, encephalopathy can cause lasting damage. In some cases, it may be irreversible. Therefore, early detection and intervention are crucial.
Synonyms Include
- Brain Disease
- Cerebral Disorder
- Brain Dysfunction
- Brain Damage
- Cerebral Insufficiency
Commonly asked questions
An Encephalopathy ICD code is used when a patient's medical record indicates a diagnosis of Encephalopathy. The specific type of Encephalopathy (e.g., unspecified, other, hepatic, toxic, metabolic) determines which ICD code is used.
Yes, Encephalopathy diagnoses are generally billable, but the specifics can depend on the patient's insurance coverage and the healthcare provider's policies. Always check with your medical billing department or software for precise billing information.
Treatment for Encephalopathy focuses on addressing the underlying cause. For instance, if a patient has hepatic encephalopathy, treatment may involve medications to decrease the production of, or remove, toxins produced by digestion that are harmful to brain cells. If a patient has toxic encephalopathy, the first step would be to eliminate exposure to the toxin. In all cases, supportive therapies such as maintaining proper nutrition, hydration, and physical therapy may also be necessary.
A diagnosis code for Encephalopathy is used to classify a diagnosis of Encephalopathy in a patient's medical record. It's used for statistical tracking, research purposes, and to determine billing and reimbursement. The code provides a standardized way to understand the patient's condition, regardless of variations in terminology.
