Drug Induced Delirium versus Toxic Encephalopathy ... - ACDIS
嚜澳rug Induced Delirium versus
Toxic Encephalopathy
ACDIS Radio 每 January 17, 2018
James S. Kennedy, MD, CCS, CDIP
President and Chief Medical Officer
CDIMD 每 Physician Champions
Smyrna, Tennessee
jkennedy@ 每 (615) 479-7021
Sharme Brodie, RN, CCS
CDI Education Specialist
HcPRO
Danvers, Massachusetts
sbrodie@ 每 (781) 639-1872
1
Disclosures
?
This presentation is designed to provide accurate and authoritative
information in regard to the subject matter covered. The information
includes both reporting and interpretation of materials in various
publications, as well as interpretation of policies of various organizations.
This information is subject to individual interpretation and to changes
over time.
每 VP-MA Health Solutions, dba CDIMD, HCPro, ACDIS, the individual speakers,
and all affiliated entities do not warrant that the written or oral opinions expressed
in this lecture apply to every situation. Prior to implementing any of the
suggestions discussed at this meeting, the attendee is advised to seek counsel
from his or her compliance officer or their legal counsel.
每 CDIMD, HCPro, ACDIS, the individual speakers, and all affiliated entities support
accurate coding of every clinical circumstance based upon physician
documentation, recognize the role and responsibility of treating physicians to
utilize language they deem appropriate to their circumstances, and support
compliance to all local, state, and federal laws.
2
Learning Objectives
? Differentiate between the manifestations and
underlying causes of drug-induced delirium
? Compliantly apply CDI and ICD-10-CM
principles
3
Complete Documentation
Altered Mental Status
?
Manifestation
每 Dementia, delirium, psychosis, vegetative state, stupor, coma
每 Unresponsive does not have a code
?
Underlying cause
每 Various encephalopathies 每 other structural diseases of the brain
每 Stroke, TIA, Alzheimer*s disease, Lewy-body dementia, encephalitis
?
Severity or specificity
每 Correlates with the severity of the manifestation
每 Acute or chronic (acute delirium is a CC; delirium NOS is not)
?
Instigating cause
每 Drug toxicity (declare if it is an overdose or if not properly taken)
每 Cerebral embolus due to atrial fibrillation
?
Consequences or complications
每 Acute respiratory failure
每 SIADH leading to hyponatremia resulting in a metabolic encephalopathy
4
DSM-V Definition of Delirium
Source: DSM-V
5
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