Resistance to antimicrobials, methicillin (anti-staph penicillins): Difference between revisions
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| OldDxArticle = MRSA Colonization (without Infection) | | OldDxArticle = MRSA Colonization (without Infection) | ||
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{{ICD10 dx | {{ICD10 dx | ||
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{{ICD10 category|Infectious disease}}{{ICD10 category|Antibiotic resistance}} | {{ICD10 category|Infectious disease}}{{ICD10 category|Antibiotic resistance}} | ||
== Additional Info == | == Additional Info == | ||
*As of 2019, the way that the microbiology laboratory indicates in its reports that an organism is resistant to the antistaphlococcal penicillins (of which the architype is methicillin, hence the phrase "Methicillin-resistant staph aureus") is to specifically identify that it is resistant to oxacillin, with a comment that "MRSA has been isolated". It will NOT list any other of this class of drugs. | |||
{{ICD10 nonstandard code | {{ICD10 nonstandard code | ||
| exception_type = CA | | exception_type = CA | ||
| explanation = Antimicrobial resistance is not coded in standard ICD10. | | explanation = Antimicrobial resistance is not coded in standard ICD10. | ||
}} | }} | ||
=== List of Antimicrobials Relevant Here === | |||
Methicillin, nafcillin, oxacillin, cloxacillin, dicloxacillin, flucloxacillin [https://en.wikipedia.org/wiki/Antistaphylococcal_penicillins] | |||
{{ICD10 Guideline MRSA}} | {{ICD10 Guideline MRSA}} | ||
{{ICD10 Guideline Infection}} | |||
{{ICD10 Guideline Combined dx AB resistance}} | |||
== Alternate ICD10s to consider coding instead or in addition == | == Alternate ICD10s to consider coding instead or in addition == | ||
{{ListICD10Category | categoryName = Antibiotic resistance}} | {{ListICD10Category | categoryName = Antibiotic resistance}} | ||
== Candidate [[Combined ICD10 codes]] == | |||
*[[Colonized with organism (not infected)]] | *[[Colonized with organism (not infected)]] | ||
== Related CCI Codes == | == Related CCI Codes == | ||
* [[Isolation, infectious]] | * [[Isolation, infectious]] | ||
Latest revision as of 10:05, 2019 December 11
| ICD10 Diagnosis | |
| Dx: | Resistance to antimicrobials, methicillin (anti-staph penicillins) |
| ICD10 code: | U82.1 |
| Pre-ICD10 counterpart: | ICD10 Guideline MRSA |
| Charlson/ALERT Scale: | none |
| APACHE Como Component: | none |
| APACHE Acute Component: | none |
| Start Date: | |
| Stop Date: | |
| External ICD10 Documentation | |
This diagnosis is a part of ICD10 collection.
Additional Info
- As of 2019, the way that the microbiology laboratory indicates in its reports that an organism is resistant to the antistaphlococcal penicillins (of which the architype is methicillin, hence the phrase "Methicillin-resistant staph aureus") is to specifically identify that it is resistant to oxacillin, with a comment that "MRSA has been isolated". It will NOT list any other of this class of drugs.
This is not a standard ICD10 code but a ICD10 CA code. We added it for the following reason:
See Non-standard ICD10 Diagnoses for other codes like this. |
List of Antimicrobials Relevant Here
Methicillin, nafcillin, oxacillin, cloxacillin, dicloxacillin, flucloxacillin [1]
Colonization
You can use the "set MRSA Colonized" button to enter the following:
- Combined code the following as a Comorbid Diagnosis (not as an Admit Diagnosis.
- Enter CCI Picklist Isolation, infectious, likely as Acquired Procedure, but consult Admit Procedure/Acquired Procedure to be sure.
Infection
Combined code the following
- the appropriate code from one of the following
Colonized vs local infection
- If MRSA drawn from an abscess or deep in wound and you think it is causing the "local" infection, else code colonization.
Data Use
Julie reported in 2013 that in the past 2 years there were 2 requests for data related to these variables.
Infections
Infections in ICD10 have combined coding requirements for some of their pathogens. Any that have antibiotic resistances would store those as Combined ICD10 codes as well. If the infection is acquired in the hospital, see Nosocomial infection, NOS. See Lab and culture reports for confirmation and details about tests. See Infections in ICD10 for more general info.
Possible Simultaneous Presence of Multiple Different Types of Infection in a Single Site
- This refers to the situation where there may be simultaneous infection with multiple types of organisms -- e.g. 2 of bacteria, virus, fungus. While a classic example is a proven viral pneumonia (e.g. influenza) with a suspected/possible bacterial pneumonia superimposed, this kind of thing can occur in places other than the lungs, e.g. meningitis.
- The "signature" of this is typically the patient being treated simultaneously with antimicrobial agents for multiple types of organisms. BUT don't confuse this with there being infections at DIFFERENT body sites.
- As per our usual practice, we will consider a diagnosis as present if the clinical team thinks it's present and are treating it, with the exception that the team initially treated for the possible 2nd type of infection but then decided it likely was NOT present and stopped those agents.
- And remember that Infectious organism, unknown is used when the the specific organism is unknown (this could be not knowing the TYPE of organism, or suspecting the type but not having identified the specific organism of that type), while when the organism has been identified but it's not in our bug list, THEN use Bacteria, NOS, Virus, NOS or Fungus or yeast, NOS.
Attribution of infections
Antibiotic resistance
Antibiotic resistance is coded as Combined ICD10 codes of the condition/pathogen and the resistance. See Antibiotic Resistant Organism for more info.
Alternate ICD10s to consider coding instead or in addition
Candidate Combined ICD10 codes
Related CCI Codes
Related Articles
Show all ICD10 Subcategories