Shock, septic: Difference between revisions
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*Also recognize that not all vasodilatory (aka distributive) shock is due to infection. When it is due to infection then use THIS code, when it's not due to infection, then use one of the other appropriate codes, such as: '''[[Anaphylactic reaction (anaphylaxis)]]''', or '''[[Shock, NOS]]''' | *Also recognize that not all vasodilatory (aka distributive) shock is due to infection. When it is due to infection then use THIS code, when it's not due to infection, then use one of the other appropriate codes, such as: '''[[Anaphylactic reaction (anaphylaxis)]]''', or '''[[Shock, NOS]]''' | ||
*If you code this, then do NOT also code [[Severe sepsis]] | *If you code this, then do NOT also code [[Severe sepsis]] | ||
{{Discussion}} | |||
Are we to switch now and use this definition as written and not our old definition which was more detailed?[[User:GHall|GHall]] 08:41, 2018 August 30 (CDT) | |||
== Alternate ICD10s to consider coding instead or in addition == | == Alternate ICD10s to consider coding instead or in addition == | ||
Revision as of 08:41, 30 August 2018
| ICD10 Diagnosis | |
| Dx: | Shock, septic |
| ICD10 code: | R57.2 |
| Pre-ICD10 counterpart: | Septic Shock |
| Charlson/ALERT Scale: | none |
| APACHE Como Component: | none |
| APACHE Acute Component: | 2019-0: Sepsis |
| Start Date: | |
| Stop Date: | |
| External ICD10 Documentation | |
This diagnosis is a part of ICD10 collection.
Additional Info
- Even though as of November 2017 ICD-10 has not yet been modified to reflect it, we are using the 2016 consensus definition of sepsis and septic shock (JAMA 315(8):801-10, 2016). These new definitions completely do away with talking about the Systemic Inflammatory Response Syndrome (SIRS). In the 2016 definitions we have just 2 subcategories:
- Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection -- NOTE this was the 2001 definition of "severe sepsis"
- Septic shock is a subset of sepsis in which profound circulatory, cellular and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone
- CRITERIA for the SHOCK in Septic Shock:
- Persisting hypotension requiring vasopressors to maintain MAP>65mmHg AND serum lactate>2 mmol/L -- both despite adequate volume resuscitation.
- The CAUSE is proven infection OR presumed infection -- thus positive cultures are not required.
- So, for example, if someone has another obvious cause of shock (e.g. massive hemorrhage) and also has infection, that does not mean it is combined hemorrhagic and septic shock. Basically, septic shock should not be called if there is another obvious cause for shock.
- Also recognize that not all vasodilatory (aka distributive) shock is due to infection. When it is due to infection then use THIS code, when it's not due to infection, then use one of the other appropriate codes, such as: Anaphylactic reaction (anaphylaxis), or Shock, NOS
- If you code this, then do NOT also code Severe sepsis
Template:Discussion Are we to switch now and use this definition as written and not our old definition which was more detailed?GHall 08:41, 2018 August 30 (CDT)
Alternate ICD10s to consider coding instead or in addition
| shock codes: |
- Anaphylactic reaction (anaphylaxis) -- includes anaphylactic shock
- Bacteremia AND Fungemia, NOS -- these are laboratory manifestations, and while it's OK to code them if present, if you do so you should also code the clinical manifestation (such as sepsis, etc).
Candidate Combined ICD10 codes
- Also code the causative infection.
Related CCI Codes
Related Articles
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