Emergency Department Coding & Reimbursement Alert

Reader Questions: Find the Injury for Shock Code

- Published on Sat, Jan 29, 2005

Question: What is the diagnosis code for neurogenic shock? I can't find it in the ICD-9 manual.
Oklahoma Subscriber

Answer: Volume II of ICD-9 refers to the specific spinal injury to find the code. If appropriate, you may want to consider 958.4 (Traumatic shock) or 306.2 (Neurocirculatory asthenia).
Neurogenic shock is usually due to an injury that affects the patient's spinal cord - frequently the area involved with sympathetic nerve centers. These patients have warm extremities, as opposed to other shock states in which the extremities are cool due to the constriction of the blood vessels. They have usually suffered a serious traumatic spinal injury.
The shock state (low blood pressure) is due to loss of sympathetic control (the nerves that allow for blood vessels to constrict). Be sure not to confuse neurogenic shock with hypovolemic shock, septic shock, cardiogenic shock, and anaphylactic shock.

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