Infections in ICD10: Difference between revisions

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Infections in ICD10 are coded somewhat inconsistently. There are [[#Diagnoses where the pathogen is implied]] and [[#Diagnoses where the pathogen must be coded separately]]. [[#Coding Antibiotic Resistance]] should also be done when there is one.

== ~~Different infection types related to~~ [[~~Combined ICD10 codes~~]] ==

=== [[Dx_Date]] infections in [[Acquired Diagnosis / Complication]] ===

~~=== Diagnoses where~~ the ~~pathogen is implied ===~~

*The date we want to use is the date in which the infection first appeared clinically. This can be a very difficult determination, and may include consideration of:

~~[[:category:Infection with implied pathogen|Some infections]] are coded~~ as ~~single codes that imply~~ the ~~pathogen:~~

**Date on which the clinical signs or symptoms first appeared (e.g. fever, or dysuria, etc)

~~{{ListICD10Category | categoryName = Infection with implied pathogen}}~~

**Date on which the culture was sent --- but this can be misleading because a culture may not be sent until several days after the symptoms appear.

**Thus, as usual, you must use your clinical judgment to decide when the infection first showed up.

=== ~~Diagnoses where the pathogen must be coded separately~~ ===

=== Untreated positive cultures ===

~~[[:category:Infection requiring pathogen|Some infections]] need~~ to ~~be coded as [[Combined ICD10 codes]] of~~ the ~~condition~~ and the ~~pathogen. For example,~~ [[~~Pneumonia, bacterial~~]] and [[~~Streptococcus pneumoniae~~]].

*Probably the most common of these is urine and sputum.

*How to code these depends on what the clinical team thinks is true:

**If they're not treating because they think it's NOT an infection and instead is colonization, then code it as one or the other of: [[Colonized with organism (not infected)]] and/or something like [[Urine tests, NOS, abnormal]]

**If on the other hand, they just failed (permanently, or temporarily) to treat what became apparent later to be a real infection, then code it as an infection.

~~{{ListICD10Category | categoryName~~ = Infection ~~requiring~~ pathogen}}

=== Coding when main dx may or may not be an infection ===

Our program [[Query check ICD10 Inf Infection req Pathogen must have one|requires infections to have a pathogen]], and [[query Check_Inf_Pathogens_must_have_Infection_requiring_pathogen_or_Potential_Infection|does not allow pathogens for non-infections]]. Many of our "wastebasket" [[NOS]] codes could be used for infections and non-infections. In order to be able to code an infection with one of these, you must also code [[Infectious disease NOS]] and the [[Pathogen]] as [[Combined ICD10 codes]].

=== ~~Potential Infections~~ ===

=== Coding when the pathogen isn't clear (yet) ===

~~They can also be coded with diagnoses that can potentially have a~~ pathogen~~, but don't require one. These are usually disorders that may or may not be infectious in nature~~.

See [[Lab and culture reports]] for where to find pathogen info.

~~{{ListICD10Category | categoryName = Potential infection}}~~

~~== Which date~~ to ~~use for infections in~~ [[~~Acquired Diagnosis / Complication~~]] ==

If you don't get a presumptive pathogen and it's not a situation which relates to '''[[Infection with implied pathogen]]''', you should then use '''[[Infectious organism, unknown]]'''.''

~~{{Discuss | who = Allan | question = | For~~ '''~~acquired~~''' ~~infections ie. cystitis with a positive culture~~, ~~now that dates are to accompany acquired diagnoses~~.~~..which date is to be entered,~~

*the date culture was sent,

*the date the positive result was reported,

*or the date abx was ordered?}}

== ~~tangential questions~~ ==

=== Other related information ===

~~=== untreatd positive urine cultures~~ ===

* [[Abscess coding guideline for ICD10]]

~~might be better off in~~ [[~~Urine tests, NOS, abnormal~~]] or [[~~Colonized with organism~~ (~~not infected~~)]] ~~depending how it should be coded.~~

* [[Antibiotic Resistant Organism]] (it's is combined-coded)

~~{{Discuss | who = Allan | question = |~~

* [[Lab and culture reports]]

*~~In instances~~ of ~~positive urine cultures that are not tx with abx, what is to be coded? Ie. colonization code combined with abnormal test result?}}~~

* [[Template:ICD10 Guideline Iatrogenic]]

* [[Attribution of infections]]

==~~= time restrictions around calling things iatrogenic =~~==

==Cross Checks==

{{~~Discuss | who = Allan | question =~~ |

* Are all acquired treated UTI's (post 48 hours from admission) to be coded with an iatrogenic code? Is [[Iatrogenic, infection, urinary catheter]] coded if patient has one? The answer to this should probably go to [[Iatrogenic, infection, urinary catheter]].

** The answer to this likely applies to some or all codes in [[:Category:Iatrogenic]]. }}

== ~~Coding Antibiotic Resistance~~ ==

== Related articles ==

~~Antibiotic resistance is combined-coded, see [[Antibiotic Resistant Organism]] for more info.~~

~~== Lab confirmation of results ==~~

[[Category:Infectious disease| *]]

~~See [[Pathogens#Culture reports]]~~

~~=={{CCMDB Data Integrity Checks | needs review }}==~~

~~See~~

* [[Check Infection requiring pathogen must have at least one pathogen]]

* [[Check Infection with implied pathogen must not have a pathogen]]

* [[Check Pathogens must have Infection requiring pathogen or Potential Infection]]

** do we want to go further, e.g. "viral infections must have virus pathogens"?

* [[Check Antibiotic resistance must have pathogen or Infection with implied pathogen]]

** do we want to go further, e.g. "only a fungus can be resistant to antifungal drug"?

~~{{discussion}}~~

~~Are those it? Could we think of more? Would we want to? Ttenbergen 16:59, 2017 December 5 (CST)~~

~~If we end up with specific pages or sub-headings we should update [[Template:ICD10 Guideline Infection]] to link specifically.~~

[[Category:~~Infection~~| *]]

@@ Line 1: / Line 1: @@
 Infections in ICD10 are coded somewhat inconsistently. There are [[#Diagnoses where the pathogen is implied]] and [[#Diagnoses where the pathogen must be coded separately]]. [[#Coding Antibiotic Resistance]] should also be done when there is one.
-== Different infection types related to [[Combined ICD10 codes]] ==
+=== [[Dx_Date]] infections in [[Acquired Diagnosis / Complication]] ===
-=== Diagnoses where the pathogen is implied ===
+*The date we want to use is the date in which the infection first appeared clinically.  This can be a very difficult determination, and may include consideration of:
-[[:category:Infection with implied pathogen|Some infections]] are coded as single codes that imply the pathogen:
+**Date on which the clinical signs or symptoms first appeared (e.g. fever, or dysuria, etc)
-{{ListICD10Category | categoryName = Infection with implied pathogen}}
+**Date on which the culture was sent --- but this can be misleading because a culture may not be sent until several days after the symptoms appear.
+**Thus, as usual, you must use your clinical judgment to decide when the infection first showed up.
-=== Diagnoses where the pathogen must be coded separately ===
+=== Untreated positive cultures ===
-[[:category:Infection requiring pathogen|Some infections]] need to be coded as [[Combined ICD10 codes]] of the condition and the pathogen. For example, [[Pneumonia, bacterial]] and [[Streptococcus pneumoniae]].
+*Probably the most common of these is urine and sputum.
+*How to code these depends on what the clinical team thinks is true:
+**If they're not treating because they think it's NOT an infection and instead is colonization, then code it as one or the other of: [[Colonized with organism (not infected)]] and/or something like [[Urine tests, NOS, abnormal]]
+**If on the other hand, they just failed (permanently, or temporarily) to treat what became apparent later to be a real infection, then code it as an infection.
-{{ListICD10Category | categoryName = Infection requiring pathogen}}
+=== Coding when main dx may or may not be an infection ===
+Our program [[Query check ICD10 Inf Infection req Pathogen must have one|requires infections to have a pathogen]], and [[query Check_Inf_Pathogens_must_have_Infection_requiring_pathogen_or_Potential_Infection|does not allow pathogens for non-infections]]. Many of our "wastebasket" [[NOS]] codes could be used for infections and non-infections. In order to be able to code an infection with one of these, you must also code [[Infectious disease NOS]] and the [[Pathogen]] as [[Combined ICD10 codes]].
-=== Potential Infections ===
+=== Coding when the pathogen isn't clear (yet) ===
-They can also be coded with diagnoses that can potentially have a pathogen, but don't require one. These are usually disorders that may or may not be infectious in nature.
+See [[Lab and culture reports]] for where to find pathogen info.
-{{ListICD10Category | categoryName = Potential infection}}
-== Which date to use for infections in [[Acquired Diagnosis / Complication]] ==
+If you don't get a presumptive pathogen and it's not a situation which relates to '''[[Infection with implied pathogen]]''', you should then use '''[[Infectious organism, unknown]]'''.''
-{{Discuss | who = Allan | question = | For '''acquired''' infections ie. cystitis with a positive culture, now that dates are to accompany acquired diagnoses...which date is to be entered,
-*the date culture was sent,
-*the date the positive result was reported,
-*or the date abx was ordered?}}
-== tangential questions ==
+=== Other related information ===
-=== untreatd positive urine cultures ===
+* [[Abscess coding guideline for ICD10]]
-might be better off in [[Urine tests, NOS, abnormal]] or [[Colonized with organism (not infected)]] depending how it should be coded.
+* [[Antibiotic Resistant Organism]] (it's is combined-coded)
-{{Discuss | who = Allan | question = |
+* [[Lab and culture reports]]
-*In instances of positive urine cultures that are not tx with abx, what is to be coded? Ie. colonization code combined with abnormal test result?}}
+* [[Template:ICD10 Guideline Iatrogenic]]
+* [[Attribution of infections]]
-=== time restrictions around calling things iatrogenic ===
+==Cross Checks==
-{{Discuss | who = Allan | question = |
+{{Data Integrity Check List|}}
-* Are all acquired treated UTI's (post 48 hours from admission) to be coded with an iatrogenic code? Is [[Iatrogenic, infection, urinary catheter]] coded if patient has one? The answer to this should probably go to [[Iatrogenic, infection, urinary catheter]].
-** The answer to this likely applies to some or all codes in [[:Category:Iatrogenic]]. }}
-== Coding Antibiotic Resistance ==
+== Related articles ==
-Antibiotic resistance is combined-coded, see [[Antibiotic Resistant Organism]] for more info.
+{{Related Articles}}
-== Lab confirmation of results ==
+[[Category:Infectious disease| *]]
-See [[Pathogens#Culture reports]]
-=={{CCMDB Data Integrity Checks | needs review }}==
-See
-* [[Check Infection requiring pathogen must have at least one pathogen]]
-* [[Check Infection with implied pathogen must not have a pathogen]]
-* [[Check Pathogens must have Infection requiring pathogen or Potential Infection]]
-** do we want to go further, e.g. "viral infections must have virus pathogens"?
-* [[Check Antibiotic resistance must have pathogen or Infection with implied pathogen]]
-** do we want to go further, e.g. "only a fungus can be resistant to antifungal drug"?
-{{discussion}}
-Are those it? Could we think of more? Would we want to? Ttenbergen 16:59, 2017 December 5 (CST)
-If we end up with specific pages or sub-headings we should update [[Template:ICD10 Guideline Infection]] to link specifically.
-[[Category:Infection| *]]