"Patient was admitted and started on gentle IV hydration, narcotics held and ambien held. He returned to his baseline mental status without other intervention. U/A, CXR, blood testing all without evidence for an infectious source contributing to his altered mental status. It appears that likely this may have been cumulative effect from medications in the background of likely mild cognitive impairment vs mild dementia leading to delirium. Discussed with patient and his wife, would likely benefit from cognitive testing as outpatient once he has completely returned to his baseline."Wouldn't T65.891A-Y, (toxic effects code) be Pdx, with G92-Y (toxic encephalopathy) as Sdx, due to the cumulative effects per documentation? (T40.2X5A-Y, adverse effects of other & T42.6X5A-Y adverse effects of other antiepileptics are listed 3rd & 4th as dx's.) I really appreciate any and all feedback. Thanks!!!!!