Note from the ACDIS Editor: Encephalopathy help for confusing times

By Linnea Archibald

While I’m tempted to start with a joke about encephalopathy being confusing, it turns out the ACDIS website has a number of helpful resources to provide some clarity and ease some of the uncertainty surrounding the diagnosis.

According to a recent ACDIS poll, encephalopathy ranks in the top 10 queried diagnoses for CDI professionals, which likely doesn’t surprise many. Encephalopathy is also a frequent denial subject, according to James S. Kennedy, MD, CCS, CDIP, in the September/October 2017 edition of the CDI Journal. In fact, the diagnosis is such a problem-child for CDI professionals, that it’s often one of ACDIS’ top search results each month.

Recently, Coding Clinic answered a question about coding encephalopathy due to a urinary tract infection and another question about coding the diagnosis when the provider documents a specific cause versus an unknown etiology. Boot Camp Instructor Sharme Brodie, RN, CCDS, discussed both of these developments in her regular “Coding Clinic for CDI” column in the Journal.

Like Coding Clinic, ACDIS also gets a number of questions about encephalopathy from members. Here are a few of the most recent ones:

• “Denials related to disorders of the brain and sepsis”
• “Coding ongoing encephalopathy after a subdural hematoma”
• “Reporting altered mental status and encephalopathy”
• “CVA and stroke related to encephalopathy”
• “Encephalopathy ‘off baseline’”

 Though this topic is a sore spot for many in CDI, rest assured that there are resources available to you. If you’re struggling with ICD-10 coding related to altered mental status and encephalopathy, read this article from Dr. Kennedy on the ACDIS Blog. If you’re looking for some best practice documentation tips on this subject, read this article from Brodie. Or, if you want to hear both experts speak on the topic, listen to this episode of ACDIS Radio featuring both Dr. Kennedy and Brodie. While you're in the Radio archives, check out the August 15 episode featuring Dawn R. Valdez, RN, LNC, CDIP, on this topic too.

And, if you’re looking for something in particular or have a specific question, don’t hesitate to post about it on the ACDIS Forum or email me directly. The ACDIS community is here to help!

Editor’s note: Archibald is the editor for ACDIS. Contact her at larchibald@acdis.org.