Neurology & Pain Management Coding Alert

Question: Encounter notes indicate that the patient suffered from immune effector cell-associated neurotoxicity syndrome (ICANS). During testing, the provider noted that the patient “awakened spontaneously with confusion but no neurologic deficits. No motor weakness. Conversed with mild hesitation. No motor weakness, seizure, hemorrhage, or edema.” What grade of ICANS would this be?

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Answer: You should check with your provider, but this sounds like mild ICANS, which you’d report with G92.01 (Immune effector cell-associated neurotoxicity syndrome, grade 1). The ICANS ICD-10 codes are differentiated by grades, with grade 1 being the mildest form. The ICANS ICD-10 codes, in order, are:

• G92.00 (Immune effector cell-associated neurotoxicity syndrome, grade unspecified)
• G92.01
• G92.02 (Immune effector cell-associated neurotoxicity syndrome, grade 2)
• G92.03 (Immune effector cell-associated neurotoxicity syndrome, grade 3)
• G92.04 (Immune effector cell-associated neurotoxicity syndrome, grade 4)
• G92.05 (Immune effector cell-associated neurotoxicity syndrome, grade 5)

Best bet: Check the characteristics for each grade of ICANS before selecting a grade that best represents the patient’s condition.