# Has anyone had to code Neurogenic Shock?



## lorabelk (Jan 25, 2012)

It is a real diagnosis, however not listed in I9 or I10. 785.59??


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## AthensCoder (Jan 26, 2012)

This is what I found of the condition:
Neurogenic shock is a distributive type of shock resulting in hypotension, occasionally with bradycardia, that is attributed to the disruption of the autonomic pathways within the spinal cord. Hypotension occurs due to decreased systemic vascular resistance resulting in pooling of blood within the extremities lacking sympathetic tone. Bradycardia results from unopposed vagal activity and has been found to be exacerbated by hypoxia and endobronchial suction.[1] Neurogenic shock can result from severe central nervous system damage (brain injury, cervical or high thoracic spinal cord).[2] In more simple terms: the trauma causes a sudden loss of background sympathetic stimulation to the blood vessels. This causes them to relax (vasodilation)[3] resulting in a sudden decrease in blood pressure (secondary to a decrease in peripheral vascular resistance).

Neurogenic shock can be a potentially devastating complication, leading to organ dysfunction and death if not promptly recognized and treated. It is not to be confused with spinal shock, which is not circulatory in nature.

Thus this is a circulatory condition and ICD-9 directs you to code 785.59, so ye you are correct.


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## lorabelk (Jan 27, 2012)

*Sonja, You're the best!*

The MD listed Neurogenic shock first and then cardiogenic shock, an outside auditor wanted to delet the neurogenic shock but the MD would not change his diagnosis summary (which is good!). So I wanted to use the 785.59. I'll send in the appeal and stick to my guns!!
Thanks again,
Lora B.


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