Bacteremia: Difference between revisions

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*[[Bacteremia]] is a clearcut entity, which means '''bacteria circulating in the blood, and not due to contaminated blood culture'''. [[#Bacteremia is '''not''' a blind replacement for septicemia!]]

*NOTE: Bacteremia is a finding, not a specific disease. And even though the general rule is that coding findings/signs/symptoms is optional when the underlying cause is known, you should ALWAYS specifically code bactermia when present

**Furthermore, at the discretion of the data collector, they can be coded as [[Combined ICD10 codes]] with another presumed infection (e.g. Klebsiella ~~pneumonia~~ with to Klebsiella ~~bacteremia~~), but if it’s not completely clear that ~~they’re~~ related, code ~~the bacteremia seperately as “free standing”. {{DA | what do you mean by free-standing? Do you mean not to use [[Combined ICD10 codes]]? Bacteremia is in [[:Category:Infection requiring pathogen]]~~, ~~so it has to be coded with a pathogen~~. ~~Do you mean it should be coded with [[Infectious organism, unknown]] or similar? Ttenbergen 13:36, 2019 February 1 (CST); Just to clarify: when~~ a patient has septic shock and ~~we put in~~ the ~~pathogen from a positive blood culture, do we also have to code bacteremia? OR~~ is ~~this code only~~ for ~~positive blood cultures where the source is not known?--[[User:LKolesar|LKolesar]] 14:20, 2019 February 12 (CST)}}~~

**Furthermore, at the discretion of the data collector, they can be coded as [[Combined ICD10 codes]] with another presumed infection (e.g. 1.Pneumonia with Klebsiella as the bug + 2.Bacteremia with Klebsiella as the bug), but if it’s not completely clear that those two infections are related to each other, then still code them both of course, but don't 1 and 2 together.

***If you include any of the sepsis codes AND you have bacteremia, then it's a clinical decision of whether or not to link those two codes.

**When a patient has septic shock with bactermia you should code both -- and link them together if the same bug is responsible for both.

=== Bacteremia is '''not''' a blind replacement for old septicemia dx! ===

The word "septicemia" is and always has been confusing, if not completely meaningless. It has been used both to mean [[pathogens]] in the blood (which is [[bacteremia]] or [[Fungemia, NOS]]), to mean toxic products of bugs in the blood (such as LPS or endotoxin which cause some of the clinical manifestations of [[Severe sepsis]]/[[Shock, septic]]), and to mean [[sepsis]] or [[Shock, septic]]. So going forward we don't need or want a replacement for that vague entity "septicemia".

== Alternate ICD10s to consider coding instead or in addition ==

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 *[[Bacteremia]] is a clearcut entity, which means '''bacteria circulating in the blood, and not due to contaminated blood culture'''. [[#Bacteremia is '''not''' a blind replacement for septicemia!]]
 *NOTE: Bacteremia is a finding, not a specific disease.  And even though the general rule is that coding findings/signs/symptoms is optional when the underlying cause is known, you should ALWAYS specifically code bactermia when present
-**Furthermore, at the discretion of the data collector, they can be coded as [[Combined ICD10 codes]] with another presumed infection (e.g. Klebsiella pneumonia with to Klebsiella bacteremia), but if it’s not completely clear that they’re related, code the bacteremia seperately as “free standing”. {{DA | what do you mean by free-standing? Do you mean not to use [[Combined ICD10 codes]]? Bacteremia is in [[:Category:Infection requiring pathogen]], so it has to be coded with a pathogen. Do you mean it should be coded with [[Infectious organism, unknown]] or similar? Ttenbergen 13:36, 2019 February 1 (CST); Just to clarify:  when a patient has septic shock and we put in the pathogen from a positive blood culture, do we also have to code bacteremia? OR is this code only for positive blood cultures where the source is not known?--[[User:LKolesar|LKolesar]] 14:20, 2019 February 12 (CST)}}
+**Furthermore, at the discretion of the data collector, they can be coded as [[Combined ICD10 codes]] with another presumed infection (e.g. 1.Pneumonia with Klebsiella as the bug + 2.Bacteremia with Klebsiella as the bug), but if it’s not completely clear that those two infections are related to each other, then still code them both of course, but don't 1 and 2 together.
-***If you include any of the sepsis codes AND you have bacteremia, then it's a clinical decision of whether or not to link those two codes.
+**When a patient has septic shock with bactermia you should code both -- and link them together if the same bug is responsible for both.
 === Bacteremia is '''not''' a blind replacement for old septicemia dx! ===
 The word "septicemia" is and always has been confusing, if not completely meaningless.  It has been used both to mean [[pathogens]] in the blood (which is [[bacteremia]] or [[Fungemia, NOS]]), to mean toxic products of bugs in the blood (such as LPS or endotoxin which cause some of the clinical manifestations of [[Severe sepsis]]/[[Shock, septic]]), and to mean [[sepsis]] or [[Shock, septic]].  So going forward we don't need or want a replacement for that vague entity "septicemia".
+{{ICD10 Guideline repeated events}}
 == Alternate ICD10s to consider coding instead or in addition ==