Peritonitis, infectious: Difference between revisions

m Text replacement - "{{ICD10 infection}}" to "{{ICD10 Guideline Infection}}"
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{{ICD10 transition status
{{ICD10 transition status
| OldDxArticle =Peritonitis
| OldDxArticle =Peritonitis
| CurrentStatus = reonciled
| CurrentStatus = reconciled
| InitialEditorAssigned = Louise Lemoine
| InitialEditorAssigned = not assigned
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{{ICD10 dx
{{ICD10 dx
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{{ICD10 category|Gastrointestinal}}  
{{ICD10 category|Gastrointestinal}}  
{{ICD10 category|Infectious disease}}{{ICD10 category|Infection requiring pathogen}}  
{{ICD10 category|Infectious disease}}{{ICD10 category|Infection requiring pathogen}}{{ICD10 category|Intra-abdominal infection}}  


== Additional Info ==
== Additional Info ==
incl peritoneal/abd/pelvic abscess
*Often abdominal paracentesis is done to test the fluid for WBC and cultures
*A diagnosis of SBP is usually made by finding polymorphonuclear cell (PMN, also referred to as neutrophils) count in the ascitic fluid is ≥250 (or 500) cells/mm3, and secondary causes of peritonitis are excluded
**Culture results might be negative if antibiotics were started before the sample was taken; you can still code this with a pathogen of [[Infectious organism, unknown]]
*[https://en.wikipedia.org/wiki/Peritonitis Peritonitis]
*[https://en.wikipedia.org/wiki/Peritonitis Peritonitis]
*often abdominal paracentesis is done to test the fluid for WBC and cultures
*A diagnosis of SBP is made if the polymorphonuclear cell (PMN, also referred to as neutrophils) count in the ascitic fluid is ≥250 cells/mm3, culture results are positive, and secondary causes of peritonitis are excluded


{{discussion}}
 
* I have a question many doctors put pts on antibiotics on spec for SBP even though NO tap /culture was done prior to antibiotics. Then a few days later a tap was done /the culture was negative. my question is do you code SBP /negative culture or do you only code SBP if a culture was done prior to antibiotics and the results come back positive. and or become positive during their stay in the hospital. And just ignore the fact that antibiotics were ordered for a diagnosis that could or couldnt be there.????
'''Includes'''
**  Any culture taken after antibiotics have already been started is not going to be helpful for the diagnosis, especially if negative.  If the doctors are calling it SBP because of other clinical parameters (fever, abd pain, PD pt, ultrasounds , WBC, etc), then I would call it peritonitis if no other cause is found for the other symptoms and it is being treated.  --[[User:LKolesar|LKolesar]] 13:33, 2014 October 14 (CDT)
*Generalized ("regular") acute peritonitis
*** I think the question was which entry to use as pathogen. Also, I think this question is much more general than just for Peritonitis. Is it a special case for [[No Culture Sent or Resulted]]? If so, could someone summarize this to there and link it from here? We'd want to word it to use the same words that a collector who searches for this next time would be likely to use. I would do it myself but would like someone medical to make sure I am not misunderstanding this, and you guys have a better idea what you would search for in such a situation... Ttenbergen 11:04, 2014 October 20 (CDT)
*Spontaneous Bacterial Peritonitis (SBP) -- this is an entity that occurs in people with pre-existing ascites
***I think the data collectors know how to code a pathogen or not and if the pt has been on antibiotics prior to the culture, then usually the culture will be negative.  The question was whether to code peritonitis even if the cultures are negative.  This question can be asked of any infectious diagnosis.  You have to look at the entire clincial picture and the certainty of the doctors in making the diagnosis.  Culture results alone are inadequate to making a diagnosis for various reasons.  They can affirm a diagnosis but are never a separate entity.  --[[User:LKolesar|LKolesar]] 11:22, 2014 October 20 (CDT)
*Abscesses that aren't included in the Alternative codes listed below, thus included in ''this'' code are:
**** so we agree that this is about more than just peritonitis. I take your point about the pathogen part. So, does anyone have a suggestion how they would search for it in a way that is not DX specific? Because this question must be an FAQ and I want to make sure the answer can be found. So this is a question to anyone out there - how would you search for this answer on the wiki?
**Intra-abdominal abscess (intraabdominal abscess) or abdominal abscess
**Pelvic abscess (intrapelvic abscess) or pelvic abscess that don't have any additional information about where it originated (e.g. as below, abscesses related to diverticulitis or appendicitis, and a few others, have their own specific codes)
 
'''EXCLUDES'''
*the specific causes/types of abdominal or pelvic infections as listed below
{{ListICD10Category | categoryName = Intra-abdominal infection }}
== Alternate ICD10s to consider coding instead or in addition ==
== Alternate ICD10s to consider coding instead or in addition ==
*[[Appendicitis, with or without rupture or peritonitis]]
{{ListICD10Category | categoryName = Intra-abdominal infection }}
*[[Disorder of peritoneum, NOS]]
*[[Disorder of peritoneum, NOS]]


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{{ListICD10Category | categoryName = cirrhosis}}
{{ListICD10Category | categoryName = cirrhosis}}
*if coding cirrhosis also code cause of cirrhosis if known
*if coding cirrhosis also code cause of cirrhosis if known
== Related CCI Codes ==
== Related CCI Codes ==
{{Data Integrity Check List}}


== Related Articles ==
== Related Articles ==
{{Related Articles}}
{{Related Articles}}


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