“Acute” encephalopathies should ALWAYS be classified as METABOLIC or TOXIC or a combination of both.
- Acute metabolic encephalopathy
- Generally due to an internal insult, such as hypernatremia, hypoglycemia, hypoxia, etc.
- Septic encephalopathy is considered a type of metabolic encephalopathy.
- The etiology of encephalopathy should be linked when known. Always be sure to clearly document a metabolic encephalopathy in addition to etiology, when applicable.
- DO document: “acute metabolic encephalopathy due to UTI”
- DON’T document: “encephalopathy due to UTI” – if criteria to diagnosis as a metabolic encephalopathy is met. Failure to include the term metabolic or toxic codes to “other encephalopathy,” does not adequately capture patient acuity.
- Acute toxic encephalopathy
- Generally due to an external insult, such as alcohol, drug, toxin, medication, etc.
- The etiology should be documented when known.
- For example, “acute toxic encephalopathy secondary to lithium toxicity”
It is especially important to clearly state when a patient has acute encephalopathy in the setting of a chronic encephalopathy. For example, toxic encephalopathy secondary to medications in the setting of chronic hepatic encephalopathy.
Download the complete tip, Acute Encephalopathy.