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| {{DX tag |[[:Category: Infection | Infection]] | [[:Category: Medical Problem | Medical Problem]] | Septicemia (Bacteremia/Fungemia) | UPL (Universal Pathogen List) | [[4600 - Septicemia (Bacteremia/Fungemia)]] | No | 0 | '''Critical Care and Medicine''' |Currently Collected | |}} | | {{PreICD10 dx | NewDxArticle = Bacteremia }} |
| ''Note: See also [[Septic Shock]], [[Severe Sepsis]]''
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| | {{DX tag |Infection | Medical Problem | Septicemia (Bacteremia/Fungemia) | UPL (Universal Pathogen List) | 4600 - Septicemia (Bacteremia/Fungemia) | No | 0 | '''Critical Care and Medicine''' |Currently Collected | |}} |
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| ==Definition== | | ==Definition== |
| '''Septicemia/BACTEREMIA/Fungemia''' means POSITIVE blood culture. | | '''Septicemia/BACTEREMIA/Fungemia''' , (blood stream infection)-(BSI) means POSITIVE blood culture, (presence of pathogens in blood stream). |
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| =={{g|Guideline}}== | | == Guideline == |
| * Positive (+ ve) blood cultures | | * Positive (+ ve) blood cultures |
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| | * [[Unknown Pathogen]] only used for septicemia if the patient was transferred from a hospital where positive blood cultures were found but it is unclear which organism it was because it was not included in the documentation sent with the patient. |
| * Septicemia/Bacteremia/Fungemia is the working DX that the physician is treating | |
| ** no blood cultures was sent, code as septicemia (46)– no blood culture sent (92)
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| ** a blood culture was sent, code as septicemia (46) - '''and'''
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| *** (a pathogen subcode) '''OR'''
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| *** negative blood culture (64) '''OR'''
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| *** Unknown pathogen(68), if you are not clear which bug is causing the infection
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| ==Examples==
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| ''Physicians in general, follow their own varied and inconsistent guidelines when documenting the diagnosis of septicemia, severe sepsis or shock therefore it can be a challenge for data collectors particularly when the DX is septic shock or severe sepsis.'' The examples here provide a guideline for collectors on how to code. [[User:TOstryzniuk|TOstryzniuk]] 10:20, 23 December 2008 (CST)
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| ===Patient admitted with urosepsis, treated, affecting blood culture results===
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| *When a patient has been admitted with '''urosepsis''' as an example, and has been determined by the physician to be '''septicemic''' and has received '''antibiotics before the blood cultures''' have been drawn and thereby affecting the results showing negative culture. Coding criteria for septicemia on page 10 of diagnosis code book is defined as "positive blood cultures".
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| ====Instructions====
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| #septicemia (46) – subcode (65) –negative culture (if a blood culture was sent & no bugs) '''AND'''
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| #[[urosepsis]] (cystitis, bladder infection)(51) – subcode (65)- negative culture (if a urine culture was sent & no bugs) or subcode (92) –if no urine culture sent.''[[User:TOstryzniuk|TOstryzniuk]] 10:20, 23 December 2008 (CST)
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| ===Physician Recording Sepsis without +ve blood culture ===
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| "I don't expect a collector to make the DX or debating with the physician about it therefore code the physician's working DX for this problem. Of course if chart notes are really not clear you can ask the physician."(Trish)
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| Physicians are recording the diagnosis of '''septicemia''' even when '''blood cultures''' are '''negative''' (negative cultures even with no antibiotics given pre blood cultures draw). Is capturing '''cystitis with a bug''', if found, adequate and '''septicemia''' should '''''not''''' be coded, or use code '''septicemia''' and subcode as '''“culture negative'''” if physician is calling it septicemia? Do we code as septicemia subcode “negative culture”?
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| ====Instructions====
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| #''septicemia (46) – subcode (65) –negative culture (blood culture was sent & no bugs ID'd).'' '''AND'''
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| #''urosepsis (51) – subcode (XX) type of bug ID’d''
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| [[User:TOstryzniuk|TOstryzniuk]] 10:20, 23 December 2008 (CST)
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| ===Physician recording severe sepsis or septic shock when not all criteria are met===
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| "I don't expect a collector to make the DX or debating with the physician about it therefore code the physician's working DX for this problem. Of course if chart notes are really not clear you can ask the physician."(Trish)
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| ====Instructions ====
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| If sepsis is the working DX that the physician is treating then this is what the collector must code as the DX.
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| [[User:TOstryzniuk|TOstryzniuk]]10:20, 23 December 2008 (CST).
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| ===Does this mean the definition has changed?===
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| Change to these instructions raised the concern that it conflicts with pervious instructions from the collection guide. Trish stated that there was no change. Instead the change to this article was meant to clarify that "''Negative or inconclusive blood cultures do not preclude a diagnosis of septicemia in patients with clinical evidence of the condition.''"[[User:TOstryzniuk|TOstryzniuk]] 17:12, 7 January 2009 (CST)--
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| There are concerns that this caveat will result in a lack of vigilance to only collect true septicemias rather than taking the doctor's word for it.
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| The change in these rules might result in over-reporting, but for research purposes over-reporting is much more easily corrected than under-reporting, since a patient can easily be excluded from research if chart review shows they do not match criteria.
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| | ===Physician Recording Septicemia without +ve blood culture === |
| | *If this happens it is best to ask the physician about this. Usually they mean septic not septicemia because they are still unsure of the source. |
| | * If a source is not identified by cultures then use [[Fever NYD]] |
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| | === Alternate dx === |
| | * [[Severe Sepsis]] |
| | * [[Septic Shock]] |
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| [[Category:Diagnosis Coding]] | | [[Category:Sepsis]] |
| [[Category: Infection]]
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| [[Category: Medical Problem]]
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Legacy Content
This page is about the pre-
ICD10 diagnosis coding schema. See the
ICD10 Diagnosis List, or the following for similar diagnoses in
ICD10:
Bacteremia
Click Expand to show legacy content.
Definition
Septicemia/BACTEREMIA/Fungemia , (blood stream infection)-(BSI) means POSITIVE blood culture, (presence of pathogens in blood stream).
Guideline
- Positive (+ ve) blood cultures
- Unknown Pathogen only used for septicemia if the patient was transferred from a hospital where positive blood cultures were found but it is unclear which organism it was because it was not included in the documentation sent with the patient.
Physician Recording Septicemia without +ve blood culture
- If this happens it is best to ask the physician about this. Usually they mean septic not septicemia because they are still unsure of the source.
- If a source is not identified by cultures then use Fever NYD
Alternate dx