Understanding Extrapyramidal Symptoms (EPS) is crucial for accurate clinical documentation and medical coding. This resource provides information on EPS, including extrapyramidal side effects, diagnosis, and management. Learn about the connection between EPS and medication, along with relevant healthcare coding terms for optimal documentation. Explore resources for identifying and documenting extrapyramidal symptoms in patients to ensure accurate medical records.
Also known as
Extrapyramidal and movement disorders
Covers various movement disorders, including drug-induced extrapyramidal symptoms.
Delirium, not induced by alcohol and other psychoactive substances
Includes delirium with parkinsonism, sometimes presenting with extrapyramidal symptoms.
Poisoning by antipsychotics and neuroleptics
Adverse effects of these drugs can include extrapyramidal symptoms.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is EPS due to drug therapy?
Yes
Specify drug
No
Is it related to other disease?
When to use each related code
| Description |
|---|
| Movement disorders due to certain drugs. |
| Involuntary muscle contractions, twisting. |
| Inner restlessness, urge to move constantly. |
Coding EPS without specifying the type (e.g., dystonia, akathisia) leads to inaccurate data and potential DRG misassignment.
Miscoding drug-induced EPS as primary extrapyramidal disorders can impact quality reporting and reimbursement.
Lack of documentation specifying laterality (left, right, or bilateral) for EPS can lead to coding errors and claim denials.
Q: How can I differentiate drug-induced extrapyramidal symptoms (EPS) from other movement disorders in patients with schizophrenia?
A: Differentiating drug-induced EPS, such as akathisia, dystonia, parkinsonism, and tardive dyskinesia, from other movement disorders like essential tremor or restless legs syndrome requires careful clinical evaluation. Consider the patient's medication history, focusing on recent initiation or dose changes of antipsychotics, particularly first-generation antipsychotics (FGAs). The temporal relationship between medication changes and symptom onset is crucial. EPS typically emerge shortly after starting or increasing the dose of an FGA. Observe the specific characteristics of the movement disorder. For example, akathisia presents as subjective restlessness and an inability to sit still, while drug-induced parkinsonism manifests as bradykinesia, rigidity, and tremor. Explore how specific rating scales, such as the Barnes Akathisia Rating Scale (BARS) or the Simpson-Angus Scale (SAS) for parkinsonism, can aid in objective assessment and differentiation. Consider implementing a thorough neurological examination to rule out other potential causes of movement disorders. Learn more about the specific clinical features of each type of EPS to improve diagnostic accuracy.
Q: What are the best evidence-based management strategies for acute dystonia caused by antipsychotic medications?
A: Acute dystonia, a distressing extrapyramidal side effect (EPS) characterized by involuntary muscle contractions, often requires prompt management. First-line treatment typically involves anticholinergic agents, such as benztropine or diphenhydramine, administered intramuscularly or intravenously for rapid relief. Benzodiazepines can also be considered, particularly if the patient experiences significant anxiety alongside the dystonia. Careful monitoring of the patient's response to treatment is crucial. If symptoms persist or recur, consider adjusting the antipsychotic medication, either by reducing the dose or switching to a lower-potency agent or a second-generation antipsychotic (SGA) with a lower risk of EPS. Prophylactic anticholinergic use may be considered in patients with a history of acute dystonia, though long-term use should be carefully evaluated due to potential side effects. Explore how shared decision-making can empower patients in choosing the most appropriate management strategy for their individual needs and preferences.
Patient presents with extrapyramidal symptoms (EPS), possibly drug-induced extrapyramidal side effects, secondary to antipsychotic medication. Clinical manifestations include akathisia characterized by subjective restlessness and objective motor restlessness, dystonia presenting as involuntary muscle contractions and spasms, and parkinsonism with symptoms such as tremor, rigidity, and bradykinesia. The patient's AIMS (Abnormal Involuntary Movement Scale) score was documented to assess the severity of these movement disorders. Differential diagnosis includes restless legs syndrome, essential tremor, and other neurological conditions. Assessment for tardive dyskinesia, a potentially irreversible movement disorder, is ongoing. The current treatment plan involves medication adjustment, including consideration of anticholinergic agents for EPS management, and close monitoring for symptom improvement and potential adverse drug reactions. Patient education regarding extrapyramidal symptoms, medication compliance, and the importance of follow-up care was provided. ICD-10 coding for extrapyramidal and movement disorders will be utilized for medical billing and reporting purposes.