Respiratory failure (insufficiency), chronic: Difference between revisions

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*Note that this code covers not just overt respiratory failure, but all levels of respiratory insufficiency.

**e.g. You can use it for a chronically hypercapnic COPD patient, or for a chronically hypoxemic pulmonary fibrosis patient, etc.

*This code would likely be the main admit diagnosis to IICU for a large number of patients going to that unit

**And furthermore, it's appropriate in the ICU record prior to IICU transfer to code it as an acquired diagnosis.

*Also code the cause if known.

*Also code '''[[Chronic dependence on mechanical ventilator]]''' if present.

*Use this code for a patient who comes ~~into hospital~~ from home or a chronic care facility, where respiratory insufficiency or failure has been ~~chronically~~ present -- in this situation use this code as a [[Comorbid Diagnosis]].

*Use this code for a patient who comes to the ward or ICU from home or a chronic care facility or IICU, where respiratory insufficiency or failure has been present -- in this situation use this code as a [[Comorbid Diagnosis]]. (ie. Home O2)

**But if the patient comes to hospital with respiratory insufficiency or failure directly from any acute care facility where it FIRST developed (~~i.e~~. ~~was not present prior to admission to that sending acute care facility~~) ~~you do NOT use this code. This applies even if this is the third or fourth transfer during same episode of hospital care.~~

*When a patient develops chronic respiratory insufficiency or failure after the start of their current database record, code it as an '''[[Acquired Diagnosis / Complication]]'''. And the decision that this occurred will be a clinical decision, made by the data collectors.

*~~In general do NOT use this code for someone with no pre-existing~~ chronic respiratory insufficiency~~/failure, who came into hospital with (~~or ~~developed while in hospital) acute respiratory~~ failure ~~-- EXCEPT you can use this code when someone with acute respiratory failure '''evolves''' into chronic respiratory insufficiency/failure during~~ their ~~time in hospital~~, ~~for which this~~ code ~~would be a~~ '''[[Acquired Diagnosis / Complication]]'''. And the decision that this occurred will be a clinical decision, made by the data collectors.

*For a typical '''IICU''' patient, use the following codes if applicable:

**[[Respiratory failure (insufficiency), chronic]] in admit codes. (If the patient came from another unit (ex.MICU) this code would be an acquired diagnosis in that profile).

**Code the underlying cause for the respiratory failure (ex. GBS, C-spine injury, etc).

**[[Muscle, wasting/atrophy NOS]]

**[[Tracheostomy, has one]]

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

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== Related CCI Codes ==

== Related Articles ==

@@ Line 14: / Line 14: @@
 *Note that this code covers not just overt respiratory failure, but all levels of respiratory insufficiency.
 **e.g. You can use it for a chronically hypercapnic COPD patient, or for a chronically hypoxemic pulmonary fibrosis patient, etc.
+*This code would likely be the main admit diagnosis to IICU for a large number of patients going to that unit
+**And furthermore, it's appropriate in the ICU record prior to IICU transfer to code it as an acquired diagnosis.
 *Also code the cause if known.
 *Also code '''[[Chronic dependence on mechanical ventilator]]''' if present.
-*Use this code for a patient who comes into hospital from home or a chronic care facility, where respiratory insufficiency or failure has been chronically present -- in this situation use this code as a [[Comorbid Diagnosis]].
+*Use this code for a patient who comes to the ward or ICU from home or a chronic care facility or IICU, where respiratory insufficiency or failure has been present -- in this situation use this code as a [[Comorbid Diagnosis]]. (ie. Home O2)
-**But if the patient comes to hospital with respiratory insufficiency or failure directly from any acute care facility where it FIRST developed (i.e. was not present prior to admission to that sending acute care facility) you do NOT use this code.  This applies even if this is the third or fourth transfer during same episode of hospital care.
+*When a patient develops chronic respiratory insufficiency or failure after the start of their current database record, code it as an '''[[Acquired Diagnosis / Complication]]'''. And the decision that this occurred will be a clinical decision, made by the data collectors.
-*In general do NOT use this code for someone with no pre-existing chronic respiratory insufficiency/failure, who came into hospital with (or developed while in hospital) acute respiratory failure -- EXCEPT you can use this code when someone with acute respiratory failure '''evolves''' into chronic respiratory insufficiency/failure during their time in hospital, for which this code would be a '''[[Acquired Diagnosis / Complication]]'''. And the decision that this occurred will be a clinical decision, made by the data collectors.
+*For a typical '''IICU''' patient, use the following codes if applicable:
+**[[Respiratory failure (insufficiency), chronic]] in admit codes. (If the patient came from another unit (ex.MICU) this code would be an acquired diagnosis in that profile).
+**Code the underlying cause for the respiratory failure (ex. GBS, C-spine injury, etc).
+**[[Muscle, wasting/atrophy NOS]]
+**[[Tracheostomy, has one]]
 == Alternate ICD10s to consider coding instead or in addition ==
@@ Line 34: / Line 41: @@
 == Related CCI Codes ==
+{{Data Integrity Check List}}
 == Related Articles ==
 {{Related Articles}}
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