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The '''pathogens''' are a list of possible entries that make up the sub-code for diagnoses categorized as [[:Category: Infection | Infection]]. Also referred to as: [[UPL]], Universal Pathogen List.
The [[ICD10 Diagnosis List]] contains specific codes for a number of different bacteria, viruses, fungi/yeast, mycobacteria and miscellaneous types of organisms. The entire list can be found in category and subcategories:  
Pathogens are drawn from the '''[[S_Pathogens]]''' table on your PDA and in the [[CCMDB.mdb]].
{{subcat collapsible|supercategory = Pathogens}}


== Pathogen Table ==
Pathogens are coded as their own diagnosis codes:
'''For the most up-to-date list of pathogens, see your PDA or Diagnosis code book.  This is the list as of May 08 and for orientation only.'''
{{ListICD10Category | categoryName = Pathogens}}


=== Special Codes ===
They are always entered as [[Combined ICD10 codes]] with an [[Infections in ICD10|infection]], but not all infections require pathogens. See [[Template:ICD10 Guideline Infection]], [[Infections in ICD10]] for more info.
Could someone please fill in specifics about how or when these are to be used? Specifically, if we know specific bugs, are there any that should be coded implicitly even if there are others (ie precedence rules)?
==== 59 other Aspiration (early presentation, documented aspiration) ====
* pahtogen 59 should be used only in conjunction with [[HAP]] and [[CAP]]
* code code HAP or CAP with a subcode of aspiration, if this is known, as the admission code.  
* if the patient subsequently has an organism, code this as a complication (eg. HAP with subcode the organism.)


=====Discussion=====
Information about pathogens can be found in the patient's chart's [[Lab and culture reports]]; see that page for specific use instructions.
*Can someone confirm for me again when it is appropriate to use code 59 from pathogen table?--[[User:MWaschuk|MWaschuk]] 18:25, 2 March 2009 (CST)
*Can someone confirm for me again when it is appropriate to use code 59 form pathogen table (aspiration-early presentation with documentation).  Many times it occurs where the pt is in respiratory distress and requires urgent intubation and because there LOC was decreased prior to intubation the physician will document that the pt likely aspirated and cxr will show a new infiltrate or the like.  The ETT sample may or may not detect a pathogen.  Is this a HAP with subcode 59 or is this a HAP with subcode pathogen detected or negative culture.--[[User:MWaschuk|MWaschuk]] 11:26, 16 March 2009 (CDT)
**Mary-Lou, this topic was discussed with Dan Roberts at a previous meeting.  He told us to code HAP or CAP with a subcode of aspiration, if this is known, as the admission code.  Then if the patient subsequently has an organism, we are to code this as a complication (eg. HAP with subcode the organism.)  Let me know if you have any other questions about this.  --[[User:LKolesar|LKolesar]] 13:11, 16 March 2009 (CDT)
***I have moved Laura's explanation into the actual instructions for code 59. If no one changes that within a week, this discussion can be deleted. [[User:Ttenbergen|Ttenbergen]] 10:38, 8 May 2009 (CDT)


====Mixed results====
== NOS pathogens ==
*60 mixed mixed bacteria
*In each of those categories there are a number of specific bugs with their own codes (e.g. B95.3 is Strep pneumoniae)
*61 mixed mixed bacteria and yeast/fungus
*But obviously we can't list every bug of any type, so for each of those categories there is also a "wastebasket" code for "NOS".  For example, if the bug is a specific bacteria but it's not in our list, then use [[Bacteria, NOS]], etc.  These are:
*62 mixed mixed bacteria with at least one resistant gram negative
**[[Bacteria, NOS]]
*63 mixed mixed bacteria with at least one resistant gram positive (MRSA, VISA, VRSA, VRE
**[[Virus, NOS]]
*64 mixed mixed resistant bacteria (either 86 or 87) with yeast/fungus
**[[Fungus or yeast, NOS]]
 
**[[Nontuberculous mycobacteria]]
====No results====
**[[Other type of infectious organism, NOS]]
*65 other Negative Culture
*92 other No Culture Sent
 
* Sputums for AFB (Acid Fast Bacilli).  As per Dr. Kumar: a negative AFB culture is considered a '''negative culture''' and should '''not''' to be coded as '''NO C&S culture sent'''.--[[User:FLindell|FLindell]] 15:33, 6 August 2008 (CDT)
 
===Bacteria===
 
***g-ve = gram negative
***g+ve = gram positive
***R = Rod
***C = coccus
 
*Acinetobacter g-ve R
*Actinobacillus actinomycetemcomitans g-ve C-B
*Bacteriods fragilis g-ve R
*Borrelia burgdorferi (Lyme disease)[[http://www.phac-aspc.gc.ca/id-mi/lyme-fs-eng.php]]
 
*Campylobacter g-ve R
*Citrobacter diversus g-ve R
*Citrobacter feundii g-ve R
*Clostridium botulinum g+ve R
*Clostridium difficle g+ve R
*Clostridium perfingens g+ve R
*Clostridium tentani g+ve R
*Corynebacterium diphtheriae  g+ve R
*E Coli g-ve R
*Enterobacter g-ve R
*Enterococcus faecalis g+ve C
*Haemophlilus  influenzae g-ve  R  C  B
*Haemophilus ducreyi g-ve R
*Haemophilus  parainfluenzae g-ve R
*Kebsiella pneumoniae g-ve R
*Legionella sp – legionella pneumophilia  g-ve R [[http://en.wikipedia.org/wiki/Legionella_pneumophila]]
 
*Listeria monocytogenes g+ve R
*Moraxella catarrhalis g-ve R
*Morganella morganii g+ve R
*Mycoplasma pneumoniae
*Neisseria gonorrhoeae g-ve C
*Proteus mirabilis g-ve R
*Pseudomonas aeruginosa g-ve R
*Salmonella g-ve R
*Serratia g-ve R
*Shigella g-ve R
*Staphylococcus aureus g+ve C
*Staphylococcus epidermidis g+ve C
*Streptococcus agalactiae  Group B g+ve C
*Streptococcus pneumoniae g+ve C
*Streptococcus pyogenes  Group A g+ve C
*Streptococcus viridans g+ve C
*Treponema pallidum  (Syphilis)[[http://www.cdc.gov/std/Syphilis/STDFact-Syphilis.htm]]
 
===Fungi===
Aspergillus species
Blastomyces,
Candida,
Crytococcus,
Histoplasma
 
===Virus===
Adenoviruses,
Cytomegaloviruses,
Epstein-Barr virus,
Herpes simplex,
Herpes zoster,
West Nile
 
===Parasites===
Cryptosporidium,
Giardia Lamblia,
Malaria,
Pneumocystis carinii (PCP),
Toxoplasma gondii
 
===Discussion / Notes ===
{{discussion}}
*will update this list with a table. (trish pending)
 
== Data Integrity Rules==
The [[CCMDB.mdb]] runs checks for the following:
*'''no infections without pathogens'''
*'''no non-infections with pathogens'''
For details, see the coding in Access.


=== NOS vs Unknown in the context of pathogens  ===
*We must distinguish '''NOS''' from '''unknown'''.
**''NOS'' means that we do know the bug, but it's not in our list of specific pathogens
**''[[Infectious organism, unknown]]'' means we assume that there IS in fact a pathogen, but we have no idea about it's actual identity.


=== Special Codes ===
* [[Not an Infection (ICD10 pathogen alternative)]] - included for [[cross check]]s when entering [[:Category:Potential infection]]s
* [[Infectious organism, unknown]] - eg for negative culture


{{Data Integrity Check List}}


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


{{stub}}
[[Category:ICD10]]
[[Category: Infection|*]]
[[Category:Pathogens| *]]
[[Category: Infection]]
[[Category:Infectious disease| *]]
[[Category:Diagnosis Coding]]
[[Category:Data Integrity Rules]]
[[Category: Questions Diagnosis]]

Latest revision as of 11:56, 30 July 2025

The ICD10 Diagnosis List contains specific codes for a number of different bacteria, viruses, fungi/yeast, mycobacteria and miscellaneous types of organisms. The entire list can be found in category and subcategories:

Pathogens

Pathogens are coded as their own diagnosis codes:

Pathogens codes:

They are always entered as Combined ICD10 codes with an infection, but not all infections require pathogens. See Template:ICD10 Guideline Infection, Infections in ICD10 for more info.

Information about pathogens can be found in the patient's chart's Lab and culture reports; see that page for specific use instructions.

NOS pathogens

NOS vs Unknown in the context of pathogens

  • We must distinguish NOS from unknown.
    • NOS means that we do know the bug, but it's not in our list of specific pathogens
    • Infectious organism, unknown means we assume that there IS in fact a pathogen, but we have no idea about it's actual identity.

Special Codes

Data Integrity Checks (automatic list)

 AppStatus
Query check ICD10 Inf Potential Infection must have pathogen or altCCMDB.accdbdeclined
Check Inf Antibiotic resistance must have pathogen or Infection with implied pathogenCCMDB.accdbimplemented
Check Inf Infection with implied pathogen must not have a pathogen combined codeCCMDB.accdbimplemented
Query check ICD10 Inf Infection req Pathogen must have oneCCMDB.accdbimplemented
Query Check Inf Pathogens must have Infection requiring pathogen or Potential InfectionCCMDB.accdbimplemented

Related Articles

Related articles:
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