What is the appropriate diagnosis code for pediatric autoimmune neuropsychiatric disorders associated with post streptococcal infections (PANDAS)?
Assign code 279.49, Autoimmune disease, NEC, for PANDAS. Additional codes should be assigned for any manifestations (e.g., motor tic, obsessive compulsive disorder, etc.) that may be present.
Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a condition discovered in a subset of children, who developed a sudden onset or exacerbation of psychiatric symptoms or movement disorders (e.g., obsessive compulsive disorder (OCD), Tourette’s syndrome and/or motor tics) following an untreated group A beta hemolytic streptococci (GABHS) infection. An autoimmune process is responsible for the onset of symptoms. The condition is considered to be a neurological variant of rheumatic fever and involves the region of the brain referred to as the basal ganglia. Similar to rheumatic fever, PANDAS may follow a streptococcal infection, but it is not an infection. Rather, it is an inflammatory reaction caused by antineuronal antibodies. These antibodies mistake brain tissue for invading streptococci bacteria.