Bacteremia: Difference between revisions

(50 intermediate revisions by 6 users not shown)

Line 1:

{{ICD10 transition status

| OldDxArticle =Septicemia

| CurrentStatus = ~~freshly automatically generated article~~

| CurrentStatus = reconciled

| InitialEditorAssigned = Allyson Alcudia

}}

Line 9:

| BugRequired= required

}}

{{ICD10 category|Infectious disease}}{{ICD10 category|Infection requiring pathogen}}{{ICD10 category|Testing}}{{ICD10 category| Symptom/Sign}}

== Additional Info ==

*Bacteremia is a ~~lab~~ finding, not a disease. ~~Following our~~ general rule~~, code~~ symptoms~~, signs and diagnostic abnormalities~~ when the underlying ~~CAUSE~~ is ~~'''unknown'''~~. If that ~~cause is known~~, then of course ~~you must code it~~, and ~~coding the abnormal finding is optional~~.

*[[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!]]

**~~So,~~ if the ~~patient has a known infection AND/OR~~ '''[[Severe sepsis]]~~''' OR '''~~[[Shock, septic]]'~~'' you MUST code those~~.

*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. 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.

**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 ==

*[[Shock, septic]]

*[[Severe sepsis]]

*[[Sepsis (SIRS due to infection, without acute organ failure)]]

*Any infection that is the source of this bacteremia.

*[[Fungemia, NOS]]

*[[Bacterial infection, NOS]]

*[[Fever or fever of unknown origin (FUO)]]

== Candidate [[Combined ICD10 codes]] ==

*Code the organism. {{ICD10~~|needs review~~}} ~~If you knew~~ the organism ~~then why would it be coded as NOS in the first place? Ttenbergen 23:22, 2017 November 17 (CST)~~

*Code the organism

*Others, as mentioned above.

== Related CCI Codes ==

== Related Articles ==

@@ Line 1: / Line 1: @@
 {{ICD10 transition status
 | OldDxArticle =Septicemia
-| CurrentStatus = freshly automatically generated article
+| CurrentStatus = reconciled
 | InitialEditorAssigned = Allyson Alcudia
 }}
@@ Line 9: / Line 9: @@
 | BugRequired= required
 }}
-{{ICD10 category|Infectious disease}}{{ICD10 category|Infection requiring pathogen}}{{ICD10 category|Testing}}
+{{ICD10 category|Infectious disease}}{{ICD10 category|Infection requiring pathogen}}{{ICD10 category|Testing}}{{ICD10 category| Symptom/Sign}}
 == Additional Info ==
-*Bacteremia is a lab finding, not a disease.  Following our general rule, code symptoms, signs and diagnostic abnormalities when the underlying CAUSE is '''unknown'''.  If that cause is known, then of course you must code it, and coding the abnormal finding is optional.
+*[[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!]]
-**So, if the patient has a known infection AND/OR '''[[Severe sepsis]]''' OR '''[[Shock, septic]]''' you MUST code those.
+*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. 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.
+**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 ==
 *[[Shock, septic]]
 *[[Severe sepsis]]
+*[[Sepsis (SIRS due to infection, without acute organ failure)]]
 *Any infection that is the source of this bacteremia.
 *[[Fungemia, NOS]]
+*[[Bacterial infection, NOS]]
+*[[Fever or fever of unknown origin (FUO)]]
 == Candidate [[Combined ICD10 codes]] ==
-*Code the organism. {{ICD10|needs review}} If you knew the organism then why would it be coded as NOS in the first place? Ttenbergen 23:22, 2017 November 17 (CST)
+{{ICD10 Guideline Infection}}
+*Code the organism
 *Others, as mentioned above.
-== Related  CCI Codes ==
+== Related CCI Codes ==
+{{Data Integrity Check List}}
 == Related Articles ==
 {{Related Articles}}
 {{ICD10 footer}}
 {{EndPlaceHolder}}