Locked-in state

This diagnosis code signifies a rare neurological condition characterized by complete paralysis of all voluntary muscles except for the eyes. Patients are fully conscious and aware of their surroundings but are unable to move or speak, communicating solely through eye movements. It results from damage to the brainstem, often due to stroke, trauma, or demyelinating diseases.

This code is appropriate for patients diagnosed with locked-in syndrome, where there is clear documentation of preserved consciousness despite quadriplegia and aphonia. Documentation should explicitly state "locked-in state" or describe the characteristic clinical presentation of complete motor paralysis with intact cognitive function and vertical eye movement.

• Differentiate from persistent vegetative state or coma; patients with locked-in state are fully conscious.
• Always code the underlying cause (e.g., stroke, brainstem lesion) first, as this is a manifestation.
• Ensure documentation clearly distinguishes between partial and complete locked-in states, as this code represents the complete form.