Significant complications

 Legacy - this list was set up when CCMDB had LIMITED slot for complication codes.  6 expanded to 9.  We no longer have limited fields, therefore this list is no longer necessary.

These complications/acquired diagnosis are the most important to look for and code preferential to all other codes available for complication.

• Complication/acquired DX code:

1. Central Line complication (requires transfusion or surgery)

• 86000 - Central Line Related Blood stream Infection (CLR-BSI) (see UPL for subcode 1-95 - not all subcodes apply and we have no rules to exclude any)
• 98003 Pneumothorax (iatrogenic) - Central Line (SG, IJ, Cordis, Subcl)
• 98102 Hemothorax – 2nd to central line insertion
• 98201 Significant bleed - 2nd to central line - Femoral Artery/vein
• 98203 Significant bleed - 2nd to central line - Pulmonary Artery
• 98203 Significant bleed - 2nd to central line - subclavian arter/vein
• 98205 Significant bleed - tamponade 2nd to central line
• 98300 Stroke due to central line
• 98500 Ischemia 2nd to central line (swan ganz, IJ, Subclavian)
• 98900 Loss or broken guidewire with central line insertion
• 99000 Arterial insertion of venous central line (malpositioning of PA or IJ into carotid artery or LV).

2. DVT Art/Ven Embolus/Thrombus -do you just want just lower extremity DVT or any other type?

• 13200 (code by itself is mixed bag of Arterial or venous embolus or Thrombus)
• 13201 Femoral (lower extremity)
• 13202 Popiteal (lower extremity)
• 13203 Subclavian (upper extremity/thorax-armpit, collar bone area)
• 13204 Superior mesenteric (abdomin)
• 13205 Post Operative (anywhere in body)
• 13206 Internal Jugular (upper extremity/thorax –neck area)
• 13208 Axillary (upper extremity/thorax-armpit - collar bone area)
• 13209 Innominate (upper extremity/thorax -)
  • 13606 aortic – Excluded because this is generally a paradoxical embolization of DVT thrombus into the aorta. Our code is a mixed bag of arterial venous embolus or thrombus so don’t include for DVT.

3. Ulcers - Decubitus only

• 94500 Decubitus ulcer only (used without subcode if stage unknown)
• 94501 stage 1 surface reddening
• 94502 just under skin
• 94503 deep to muscle
• 94504 full layer to bone

4. HAP-Hospital Acquired Pneumonia

• 3800 (UPL subcodes 1-95 (exclude subcode 59, see below))
• 3600 (UPL subcodes 1-95 (Pneumonia if not sure if hosp or community acquired, exclude subcode 59))

5. Aspiration Pneumonia Aspiration (early presentation, documented aspiration)

• 3859 hospital acquired aspiration pneumonia
• 3659 Pneumonia Etiology not clear (not sure where acquired) (see discussion here)

6.Pulmonary Embolus

• 1300 Pulmonary Embolus (used without subcode if reason is unknown)
• 1301 Pulmonary Embolus- Septic
• 1302 Thrombic
• 1303 Post Operative
• 1304 Air
• 1305 Post Trauma-fat emboli – not included for medicine
• 1390 other reason (same as using 1300 when reason is unknown)

7. Cardiac Arrest

• 10001 Unwitnessed Cardiac Arrest
• 10002 Witnessed Cardiac Arrest

8. Stroke

• 50501 CVA Post angiogram
• 50502 CVA Post operative procedure
• 50504 CVA Post anticoagulation therapy
• 50505 CVA Intra-operative
• 50506 CVA Post Partum
• 50590 CVA 2nd to OTHER causes (original description in "other medical proedures)
• 98300 CVA due to central line - No Article (also see Central line complications)

9. NG tube placement problems

• 99101 Aspiration due to Malpositioning

10. Septic Shock

• 4400 (UPL subcode 1-95)

11. Severe Sepsis

• 4500 (UPLsubcodes 1-95)

12. Septicemia/Bacteremia/Fungemia

• 4600 (UPL subcode 1-95)

13. Cystitis (Bladder Infection)

• 5100

14. Esophagitis 2nd to infection

• 6400 (UPL subcode 1-95)

15. Gastroenteritis

• 6500 (subcode 1-95)

16. Neutropenic Enterocolitis

• 6800 (UPL subcode 1-95)

17. Pseudomembranous Colitis (C-DIFF)

• 7212

18. Post OP Surg Wound Infection

• 8300 (UPL subcode 1-95)

19. Soft Tissue Abscess

• 8400 (UPL subcode 1-95)

20. Soft Tissue Infection (includes Cellulitis)

• 8500 (UPL subcode 1-95)

21. Ulcers - Lower Extremity & other

• 94700

22. Tracheostomy (complications)

• 77404 obstruction
• 77405 malpositioning
• 77406 bleeding (significant)
• 77407 Fistula formation
• 77408 site infection
• 77490 any other complications

23. any Pneumothorax (iatrogenic) or old code 1101

24. Hemothorax (2nd to procedures)

• 98101 2nd to pleural tap/thoracentesis
• 98102 (see #1 above - central line complication)
• 98103 2nd to chest tube insertion
• 98190 2nd to other procedures
• 1001 Iatrogenic (the preference is to use code 981 which is more specific)

25. Mainstem intubation

• 98600

26. Aortic dissection post angioplasty

• 98700

27. Liver laceration post procedure (post chest tube or any other procedure)

• 98800

28. Cardiogenic Shock

• 10100

29. Myocardial infarction

• 10200

30. Congestive Heart Failure

• 10300

31. Upper GI Bleed

• 40100

32. Lower GI Bleed

• 40200

ICD10

These will need to be reviewed for ICD10. Template:ICD10

Or interlinking with other articles.

These should turn into a column in s_ICD10 table so collectors can filter by.

requires review

• This list should be reviewed by Critical Care Directors to verify if this is what ICU would like to continue with. Allan will bring to Steering. See also Conversion from our old diagnosis schema to ICD10/CCI‎.

Legacy

used to be two lists

• The following used to be only ICU: 28-32
• The following used to be only medicine: 13-17

when those lists were built

November, 2009 Dr.Dan Roberts had provided this list of “specific complications” that he wanted to track on medicine wards and in ICUs.

• this was done because coding slots very restricted to 6-9. They have been unlimted for long time.