AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2021 Issue 1; Ask the Editor

Toxic Metabolic Encephalopathy and Hepatic Encephalopathy

A 70-year-old patient with a history of nonalcoholic steatohepatitis (NASH) cirrhosis complicated by hepatic encephalopathy and diabetes presented to the emergency department (ED) secondary to altered mental status. The patient was admitted for a full work-up and was diagnosed with toxic metabolic encephalopathy (TME) secondary to acute on chronic hepatic encephalopathy. Is it appropriate to separately report TME when due to hepatic encephalopathy? Would TME be considered inherent to hepatic encephalopathy? How should toxic metabolic encephalopathy due to acute on chronic hepatic encephalopathy be coded? ...

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