Health data standards and systems

A patient with relapsed B cell Acute Lymphoblastic Leukaemia was admitted for Blinatumomab. Day 1 following infusion pt had MET call for hypotension, tachycardia and being febrile. This has been documented as a "presumed drug induced inflammatory response" with discharge summary calling it "cytokine release syndrome". Our haematologist has advised this is an adverse drug reaction to monoclonal antibodies, such as Blinatumomab and Moxetumomab and described it a form of systemic inflammatory response. She said it will become more common with increasing use of these drugs.

We have coded this to:
R65.2 Systemic inflammatory response, non infectious
and added a code to identify the drug Blinatumomab, a type of immunotherapy.

As there is no index entry for "cytokine release syndrome", would you please advise if this is correct. Should we also add U91 code to identify the syndrome component of the diagnosis?

Search Details
Google - "cytokine release syndrome" AKA an infusion reaction, is a form of systemic inflammatory response syndrome that is an adverse effect of some monoclonal antibody drugs". Also, "a condition that may occur after treatment with some types of immunotherapy, such as monoclonal antibodies"

For documentation of cytokine release syndrome, VICC advises to follow ACS 0005 Sydromes. As there is no one code for this syndrome assign codes for the manifestations as per ACS 0001 Principal diagnosis and ACS 0002 Additional diagnoses, followed by the external cause codes to identify the drug and U91 Syndrome, not elsewhere classified.

As there is no documentation of systemic inflammatory response syndrome (SIRS), a code from category R65 Systemic inflammatory response syndrome [SIRS] cannot be assigned.

Note: This query has been retired due to the creation of Twelfth Edition Index entry Syndrome/cytokine release (CRS) and code D89.81 Cytokine release syndrome.