Bladder, cystitis, acute infectious: Difference between revisions

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== Additional Info ==

*In a pt with '''bacteruria without symptoms''' (asymptomatic bacteruria) clinicians need to make a decision about whether they think an actual infection is present or not. The reasons is that even clean-catch urine is not truly sterile even in the absence of an actual infection. Thus, if left on the counter at room temp for long enough, any urine specimen will grow 10<sup>7</sup> colonies per mL and thus be flagged as a possible UTI. If the clinician decides that this asymptomatic bacteruria is NOT an infection, then we shouldn't code it as such. This isn't just nomenclature --- in this case it was felt that no UTI was actually present.

*Contrary to a previous Wiki rule, code this if present even IF NOT BEING TREATED (e.g. as might occur in a palliative situation, or when the bug is resistant to everything).

**One rare subtlety here is that in a palliative situation there may be a true UTI which isn't being treated -- and you should code that.

**But the subtlety here is that it's hard to distinguish whether asymptomatic bacteruria is really an infection or just a colonization, as follows: In a pt with '''bacteruria without symptoms''' (asymptomatic bacteruria) clinicians need to make a decision about whether they think an actual infection is present or not. The reasons is that even clean-catch urine is not truly sterile even in the absence of an actual infection. Thus, if left on the counter at room temp for long enough, any urine specimen will grow 10<sup>7</sup> colonies per mL and thus be flagged as a possible UTI. If the clinician decides that this asymptomatic bacteruria is NOT an infection, then we shouldn't code it as such. This isn't just nomenclature --- in this case it was felt that no UTI was actually present.

*Sometimes though, instead, asymptomatic bacteruria is felt to be clinically important and an infection, and we'll know that because it was treated. When that occurs, you should code it as [[Bladder, cystitis, acute infectious]].

== Alternate ICD10s to consider coding instead or in addition ==

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 == Additional Info ==
-*In a pt with '''bacteruria without symptoms''' (asymptomatic bacteruria) clinicians need to make a decision about whether they think an actual infection is present or not.  The reasons is that even clean-catch urine is not truly sterile even in the absence of an actual infection.  Thus, if left on the counter at room temp for long enough, any urine specimen will grow 10<sup>7</sup> colonies per mL and thus be flagged as a possible UTI.  If the clinician decides that this asymptomatic bacteruria is NOT an infection, then we shouldn't code it as such.  This isn't just nomenclature --- in this case it was felt that no UTI was actually present.
+*Contrary to a previous Wiki rule, code this if present even IF NOT BEING TREATED (e.g. as might occur in a palliative situation, or when the bug is resistant to everything).
-**One rare subtlety here is that in a palliative situation there may be a true UTI which isn't being treated -- and you should code that.
+**But the subtlety here is that it's hard to distinguish whether asymptomatic bacteruria is really an infection or just a colonization, as follows:  In a pt with '''bacteruria without symptoms''' (asymptomatic bacteruria) clinicians need to make a decision about whether they think an actual infection is present or not.  The reasons is that even clean-catch urine is not truly sterile even in the absence of an actual infection.  Thus, if left on the counter at room temp for long enough, any urine specimen will grow 10<sup>7</sup> colonies per mL and thus be flagged as a possible UTI.  If the clinician decides that this asymptomatic bacteruria is NOT an infection, then we shouldn't code it as such.  This isn't just nomenclature --- in this case it was felt that no UTI was actually present.
-*Sometimes though, instead, asymptomatic bacteruria is felt to be clinically important and an infection, and we'll know that because it was treated.  When that occurs, you should code it as [[Bladder, cystitis, acute infectious]].
 == Alternate ICD10s to consider coding instead or in addition ==