Influenza in ICD10: Difference between revisions

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==ICD10 Codes for Influenza==
==ICD10 Codes for Influenza==
*There are 4 influenza-related codes.
*There are 4 influenza-related codes we're using in ICD10.
*These 3 code for actual disease due to influenza:   
*These 3 code are for actual disease due to influenza:   
**[[Influenza pneumonia]]
**[[Influenza pneumonia]]
**[[Influenza without pneumonia but with other respiratory manifestations]]
**[[Influenza without pneumonia but with other respiratory manifestations]]
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*Lab-confirmed influenza
*Lab-confirmed influenza
**Present if the final result of the swab testing was positive -- even if the clinical team didn’t finally believe it was influenza
**Present if the ''final'' result of the testing done at Cadham was positive, and absent if not -- regardless of what the clinical team believed.
**The tricky part here is that the hospital labs are now doing a rapid swab test (which comes back very quickly) PLUS they send the materials on to the Cadham lab were the testing is re-run.  To further muddy the waters, Cadham gives a preliminary result which can be different than their FINAL result.  One thing is clear -- the final Cadham result trumps the preliminary Cadham result.  Thus we can’t ever make this determination until the final Cadham result is done.  But what’s not clear is what to do when the rapid swab test done at the hospitals is DIFFERENT than the final Cadham result.  Allan will talk to the Cadham people about that.
**The tricky part here is that the hospital labs are now doing an influenza test (which is only done on swabs, not on fluid samples, and comes back quickly) PLUS they send the materials on to the Cadham lab were the testing is re-run.  To further muddy the waters, Cadham gives a preliminary result which can be different than their FINAL result.  On 11/21/2017 Allan spoke with the medical director at Cadham (Paul Van Caeseele) who related that the Cadham tests are more sensitive than what's done in hospitals, so that (though it's not 100% perfect) we should consider the FINAL CADHAM result to represent '''the truth''' as regards lab-confirmation of influenza.
*Suspected influenza -- here the clinical team wrote believed that it was influenza and gave a “full course” of anti-influenza drug PLUS either: (a) no swab was sent at all, or (b) swab was sent and was negative.
 
*Suspected influenza -- here the clinical team wrote believed that it was influenza and gave a “full course” of anti-influenza drug PLUS either: (a) no lab test was sent at all, or (b) the final Cadham test result was negative.
**For influenza that this not severe, the usual course of oseltamivir (Tamiflu) is 5 days.  But WHO and CDC recommend that in severe cases the drug should be continued until the infection is resolved or there is satisfactory clinical improvement.  
**For influenza that this not severe, the usual course of oseltamivir (Tamiflu) is 5 days.  But WHO and CDC recommend that in severe cases the drug should be continued until the infection is resolved or there is satisfactory clinical improvement.  
*We will talk about this more later, and take account of how Infection Control does this.
*We will talk about this more later, and take account of how Infection Control does this.

Revision as of 16:57, 21 November 2017


ICD10 Codes for Influenza

Identifying the Presence of Influenza

We have not completely decided yet, but we are considering coding influenza as Lab-confirmed, or Suspected:

  • Lab-confirmed influenza
    • Present if the final result of the testing done at Cadham was positive, and absent if not -- regardless of what the clinical team believed.
    • The tricky part here is that the hospital labs are now doing an influenza test (which is only done on swabs, not on fluid samples, and comes back quickly) PLUS they send the materials on to the Cadham lab were the testing is re-run. To further muddy the waters, Cadham gives a preliminary result which can be different than their FINAL result. On 11/21/2017 Allan spoke with the medical director at Cadham (Paul Van Caeseele) who related that the Cadham tests are more sensitive than what's done in hospitals, so that (though it's not 100% perfect) we should consider the FINAL CADHAM result to represent the truth as regards lab-confirmation of influenza.
  • Suspected influenza -- here the clinical team wrote believed that it was influenza and gave a “full course” of anti-influenza drug PLUS either: (a) no lab test was sent at all, or (b) the final Cadham test result was negative.
    • For influenza that this not severe, the usual course of oseltamivir (Tamiflu) is 5 days. But WHO and CDC recommend that in severe cases the drug should be continued until the infection is resolved or there is satisfactory clinical improvement.
  • We will talk about this more later, and take account of how Infection Control does this.

Alternate ICD10s to consider coding instead or in addition

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