Denial Toxic Encephalopathy due to drugs

We are starting to see an increase in denial on  toxic encephalopathy due to drugs.  Insurance states that some level of AMS or decreased LOC is integral in cases like polypharmacy or effects of certain drugs.  We documentation linkage of toxic encephalopathy due to source.  We have GCS scores to help support.   Any thoughts or insight maybe missing?


  • Did they give u an alternate code?
  •  Are patients presenting wth encephalopathy due to drugs self-administered improperly and or with use of illegal drugs, and/or is your facility coding encephalopathy as a consequence of medical administration of therapeutic drugs with a POA of “N”?

    Sorry if seems a silly question, but it matters in context of topic.
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