Can you code Metabolic Encephalopathy to G9341 when its related to a CVA
I have reviewed multiple coding clinics and coding guidelines regarding capturing Encephalopathy with a CVA. From what I have seen Encephalopathy is not considered inherent to a CVA. My issues is when a Provider notes: Metabolic Encephalopathy due to CVA. Is it appropriate to code G9341 as an MCC or is it appropriate to only code G9349?
Thanks!
Comments
Hello,
You would code- G93.41 metabolic encephalopathy as the provider has specified an actual type of encephalopathy that is due to the CVA. The Coding Clinic from Second Quarter ICD-10 2018 Pages: 24-25 and the AHA coding handbook states to code the other encephalopathy code of G93.49 when the encephalopathy is linked to condition but a specified type of encephalopathy is not documented so like encephalopathy unspecified type due to CVA= G93.49 whereas metabolic encephalopathy due to cva=G93.41.
I hope that helps and not sure if anyone else has anything to add.
Are there any metabolic derrangements or causes to lead you to believe the patient has metabolic encephalopathy?
When I think of metabolic encephalopathy, I think of something like hyponatremia or infection or acidosis as the cause rather than a CVA. I would look for any metabolic derangements in such cases that would indicate a metabolic encephalopathy is present: anecdotally, I have not seen this charted.
Perhaps a SME on strokes can provide insight?