Clostridium difficile infection (C. diff): Difference between revisions

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== Additional Info ==
== Additional Info ==
{{Discuss | who = all, Allan, ... | question =
* <This item is actually a pathogen but our system does not recognize it as a pathogen.  When you put a diagnosis of sepsis or septic shock and add this pathogen, it does not recognize it as a pathogen.  I have two patients on my laptop currently that I cannot send because I cannot put in this as a pathogen for septic shock.  Is there some reason we cannot use this code as a pathogen?>}}
incl pseudomembraneous colitis
incl pseudomembraneous colitis


Code this if you have a patient who is diagnosed with '''pseudomembranous colitis''' and the stool culture is positive (+ve) for C.diff.  
Code this if you have a patient who is diagnosed with '''pseudomembranous colitis''' and the stool culture is positive (+ve) for C.diff.  


=== what if is a different pathogen? ===
=== what if it is is a different pathogen? ===
* Dr. Kumar states that the majority of pseudomembranous colitis is caused by C.diff and other types are '''rare.'''
* Dr. Kumar states that the majority of pseudomembranous colitis is caused by C.diff and other types are '''rare.'''
* If a patient has diarrhea and a stool culture is negative (-ve) for C.diff, then code the appropriate other [[:Category:Gastroenteritis]] code.
* If a patient has diarrhea and a stool culture is negative (-ve) for C.diff, then code the appropriate other [[:Category:Gastroenteritis]] code.

Revision as of 10:28, 2019 June 11

ICD10 Diagnosis
Dx: Clostridium difficile infection (C. diff)
ICD10 code: A04.7
Pre-ICD10 counterpart: Pseudomembranous Colitis (C-DIFF)
Charlson/ALERT Scale: none
APACHE Como Component: none
APACHE Acute Component: 2019-0: GI NOS
Start Date:
Stop Date:
External ICD10 Documentation

This diagnosis is a part of ICD10 collection.

  • SMW
    • 2019-01-01
    • 2999-12-31
    • A04.7
  • Cargo


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Additional Info

incl pseudomembraneous colitis

Code this if you have a patient who is diagnosed with pseudomembranous colitis and the stool culture is positive (+ve) for C.diff.

what if it is is a different pathogen?

  • Dr. Kumar states that the majority of pseudomembranous colitis is caused by C.diff and other types are rare.
  • If a patient has diarrhea and a stool culture is negative (-ve) for C.diff, then code the appropriate other Category:Gastroenteritis code.

Alternate ICD10s to consider coding instead or in addition

Gastroenteritis codes:

Candidate Combined ICD10 codes

Infections

Infections in ICD10 have combined coding requirements for some of their pathogens. Any that have antibiotic resistances would store those as Combined ICD10 codes as well. If the infection is acquired in the hospital, see Nosocomial infection, NOS. See Lab and culture reports for confirmation and details about tests. See Infections in ICD10 for more general info.

Possible Simultaneous Presence of Multiple Different Types of Infection in a Single Site

  • This refers to the situation where there may be simultaneous infection with multiple types of organisms -- e.g. 2 of bacteria, virus, fungus. While a classic example is a proven viral pneumonia (e.g. influenza) with a suspected/possible bacterial pneumonia superimposed, this kind of thing can occur in places other than the lungs, e.g. meningitis.
    • The "signature" of this is typically the patient being treated simultaneously with antimicrobial agents for multiple types of organisms. BUT don't confuse this with there being infections at DIFFERENT body sites.
  • As per our usual practice, we will consider a diagnosis as present if the clinical team thinks it's present and are treating it, with the exception that the team initially treated for the possible 2nd type of infection but then decided it likely was NOT present and stopped those agents.
  • And remember that Infectious organism, unknown is used when the the specific organism is unknown (this could be not knowing the TYPE of organism, or suspecting the type but not having identified the specific organism of that type), while when the organism has been identified but it's not in our bug list, THEN use Bacteria, NOS, Virus, NOS or Fungus or yeast, NOS.

Attribution of infections

See Attribution of infections


Related CCI 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

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