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| *This template addressed the large and confusing topic of ACUTE alterations in cognition
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| *It is confusing for 3 main reasons:
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| **(1) There is a large range of mental changes, from mild confusion all the way up to coma. In hospital, this range prominently includes DELERIUM, which is defined as an acute confusional state that tends to wax and wane relatively rapidly (over hours or even shorter), and may be accompanied by agitation or psychomotor depression.
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| **(2) Such alterations in cognition have MANY different causes
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| **(3) The clinical terminology is variable, confusing, and often nonspecific
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| ***For example, the terms "altered mental status", "encephalopathy" and "delerium" are often used loosely and interchangably.
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| *As usual in ICD10, you should use the most specific code available, and only use "waste basket/NOS codes" only when a more specific code is not available.
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| *First, if what you've got is actual coma, then use one of the coma codes, not delerium or encephalopathy
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| **If the cause is a substance, toxin or DRUG, use [[Encephalopathy, toxic]]
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| **If the cause is sepsis, use [[Encephalopathy, septic or metabolic]]
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| **If the cause is "metabolic" (except for hepatic encephalopathy), use [[Encephalopathy, septic or metabolic]] -- this includes electrolyte distubances (e.g. hypernatremia, hyponatremia, hypercalcemia), uremic encephalopathy, hypoglycemic, hyperglycemia
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| **If the cause is hepatic encephalopathy, use one of these:
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| ***[[Liver failure w/wo hepatic encephalopathy, acute or subacute NOS]]
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| ***[[Liver failure w/wo hepatic encephalopathy, alcoholic]]
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| ***[[Liver failure w/wo hepatic encephalopathy, chronic NOS]]
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| ***[[Liver failure w/wo hepatic encephalopathy, due to toxin/drug NOS]]
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| ***[[Liver failure w/wo hepatic encephalopathy, not specified as acute or chronic]]
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| == Codes to Consider ==
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| *Coma codes:
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| **[[Myxedema with coma]]
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| **[[Diabetic coma]]
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| **[[Coma, NOS]]
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| *Encephalopathy-related codes
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| **[[Delirium, not due to drugs or alcohol]]
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| **[[Encephalopathy, toxic]]
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| **[[Encephalopathy, septic or metabolic]]
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| **[[Encephalopathy, NOS]] -- {sc:toxic/drug-induced, metabolic, septic, hypertensive}
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| **[[Encephalopathy, hypertensive]]
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| **[[Liver failure w/wo hepatic encephalopathy, acute or subacute NOS]]
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| **[[Liver failure w/wo hepatic encephalopathy, alcoholic]]
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| **[[Liver failure w/wo hepatic encephalopathy, chronic NOS]]
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| **[[Liver failure w/wo hepatic encephalopathy, due to toxin/drug NOS]]
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| **[[Liver failure w/wo hepatic encephalopathy, not specified as acute or chronic]]
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| *Overlapping symptom codes
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| **[[Somnolence, stupor or obtundation]]
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| **[[Disorientation]]
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| **[[Amnesia]]
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| **[[Dizziness]]
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| **[[Hallucinations]]
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| **[[Agitation, restlessness]]
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| **[[Violent behavior]]
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| **[[Symptom or sign involving emotional state, NOS]]
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| *Other/misc related codes
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| **[[Anoxic brain injury, NOS]]
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| **[[Organic brain disorder, NOS]]
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| **[[Persistent vegetative state]]
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| <noinclude> | | <noinclude> |
| See body of template for details | | See body of template for details |
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| </noinclude>=== Altered mental status === | | </noinclude>=== <span style="color: green">Altered mental status coding guideline</span> === |
| {{DA | Allan, you asked me to make this page at task meeting. When you have added the content you want please let me know and I will add it to the relevant pages. }}
| | Coding altered mental status in ICD10 can be complex, see [[ICD10 Guideline for coding altered mental status]] for more info. |
See body of template for details
To use:
- {{ICD10 Guideline Altered mental status}}
Altered mental status coding guideline
Coding altered mental status in ICD10 can be complex, see ICD10 Guideline for coding altered mental status for more info.