Template:ICD10 Guideline Altered mental status

• This template addressed the large and confusing topic of ACUTE alterations in cognition
• It is confusing for 3 main reasons:
  • (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.
  • (2) Such alterations in cognition have MANY different causes
  • (3) The clinical terminology is variable, confusing, and often nonspecific
    • For example, the terms "altered mental status", "encephalopathy" and "delerium" are often used loosely and interchangably.
• 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.
  • If the cause is a substance, toxin or DRUG, use Encephalopathy, toxic
  • If the cause is sepsis, use Encephalopathy, septic or metabolic
  • If the cause is hepatic encephalopathy, use one of these:
    • Liver failure w/wo hepatic encephalopathy, acute or subacute NOS
    • Liver failure w/wo hepatic encephalopathy, alcoholic
    • Liver failure w/wo hepatic encephalopathy, chronic NOS
    • Liver failure w/wo hepatic encephalopathy, due to toxin/drug NOS
    • Liver failure w/wo hepatic encephalopathy, not specified as acute or chronic

• • Encephalopathy, toxic
  • Encephalopathy, septic or metabolic
  • Encephalopathy, NOS -- {sc:toxic/drug-induced, metabolic, septic, hypertensive}
  • Encephalopathy, hypertensive
  • Delirium, not due to drugs or alcohol
  • Coma, NOS
  • Liver failure w/wo hepatic encephalopathy, acute or subacute NOS
  • Liver failure w/wo hepatic encephalopathy, alcoholic
  • Liver failure w/wo hepatic encephalopathy, chronic NOS
  • Liver failure w/wo hepatic encephalopathy, due to toxin/drug NOS
  • Liver failure w/wo hepatic encephalopathy, not specified as acute or chronic
  • Somnolence, stupor or obtundation
  • Persistent vegetative state
  • A variety of codes for liver failure with encephalopathy
  • A variety of codes relating to overdoses (including iatrogenic), withdrawal, etc.
  • Anoxic brain injury, NOS
  • Organic brain disorder, NOS
  • Disorientation
  • Amnesia
  • Dizziness
  • Hallucinations
  • Agitation, restlessness
  • Violent behavior
  • Symptom or sign involving emotional state, NOS

See body of template for details

To use:

{{ICD10 Guideline Altered mental status}}

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Altered mental status

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