Bacteremia: Difference between revisions
Ttenbergen (talk | contribs) m Text replacement - "== Alternate ICD10s to consider coding instead or in addition ==" to "{{ICD10 Guideline repeated events}} == Alternate ICD10s to consider coding instead or in addition ==" |
Ttenbergen (talk | contribs) m Text replacement - "== Alternate ICD10s to consider coding instead or in addition ==" to "{{ICD10 Guideline repeated events}} == Alternate ICD10s to consider coding instead or in addition ==" |
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=== Bacteremia is '''not''' a blind replacement for old septicemia dx! === | === Bacteremia is '''not''' a blind replacement for old septicemia dx! === | ||
The word "septicemia" is and always has been confusing, if not completely meaningless. It has been used both to mean [[pathogens]] in the blood (which is [[bacteremia]] or [[Fungemia, NOS]]), to mean toxic products of bugs in the blood (such as LPS or endotoxin which cause some of the clinical manifestations of [[Severe sepsis]]/[[Shock, septic]]), and to mean [[sepsis]] or [[Shock, septic]]. So going forward we don't need or want a replacement for that vague entity "septicemia". | The word "septicemia" is and always has been confusing, if not completely meaningless. It has been used both to mean [[pathogens]] in the blood (which is [[bacteremia]] or [[Fungemia, NOS]]), to mean toxic products of bugs in the blood (such as LPS or endotoxin which cause some of the clinical manifestations of [[Severe sepsis]]/[[Shock, septic]]), and to mean [[sepsis]] or [[Shock, septic]]. So going forward we don't need or want a replacement for that vague entity "septicemia". | ||
{{ICD10 Guideline repeated events}} | |||
{{ICD10 Guideline repeated events}} | {{ICD10 Guideline repeated events}} | ||
Revision as of 13:27, 3 July 2019
| ICD10 Diagnosis | |
| Dx: | Bacteremia |
| ICD10 code: | A49.9 |
| Pre-ICD10 counterpart: | none assigned |
| Charlson/ALERT Scale: | none |
| APACHE Como Component: | none |
| APACHE Acute Component: | none |
| Start Date: | |
| Stop Date: | |
| Data Dependencies(Reports/Indicators/Data Elements): | No results |
| External ICD10 Documentation | |
This diagnosis is a part of ICD10 collection.
|
This lists as Apache Neuro and is in APACHE Acute Dxs in ICD10 codes because it is in the following range: Nonop - Large categories - Neuro NOS - A17. - A69.22 When we touched on this at an Allan's list meeting you agreed that probably wasn't right. Emailed Allan. Ttenbergen 15:42, 2019 June 25 (CDT) |
Additional Info
- Bacteremia is a clearcut entity, which means bacteria circulating in the blood, and not due to contaminated blood culture. #Bacteremia is not a blind replacement for septicemia!
- NOTE: Bacteremia is a finding, not a specific disease. And even though the general rule is that coding findings/signs/symptoms is optional when the underlying cause is known, you should ALWAYS specifically code bactermia when present
- Furthermore, at the discretion of the data collector, they can be coded as Combined ICD10 codes with another presumed infection (e.g. 1.Pneumonia with Klebsiella as the bug + 2.Bacteremia with Klebsiella as the bug), but if it’s not completely clear that those two infections are related to each other, then still code them both of course, but don't 1 and 2 together.
- When a patient has septic shock with bactermia you should code both -- and link them together if the same bug is responsible for both.
Bacteremia is not a blind replacement for old septicemia dx!
The word "septicemia" is and always has been confusing, if not completely meaningless. It has been used both to mean pathogens in the blood (which is bacteremia or Fungemia, NOS), to mean toxic products of bugs in the blood (such as LPS or endotoxin which cause some of the clinical manifestations of Severe sepsis/Shock, septic), and to mean sepsis or Shock, septic. So going forward we don't need or want a replacement for that vague entity "septicemia".
Repeated events
If this happens repeatedly during the same ward or unit stay, only code it the first time it happens, regardless of whether it is an Admit Diagnosis or Acquired Diagnosis, rather than each time it happens. See ICD10 codes only coded the first time for other diagnoses coded this way.
| Example: |
|
Repeated events
If this happens repeatedly during the same ward or unit stay, only code it the first time it happens, regardless of whether it is an Admit Diagnosis or Acquired Diagnosis, rather than each time it happens. See ICD10 codes only coded the first time for other diagnoses coded this way.
| Example: |
|
Alternate ICD10s to consider coding instead or in addition
- Shock, septic
- Severe sepsis
- Sepsis (SIRS due to infection, without acute organ failure)
- Any infection that is the source of this bacteremia.
- Fungemia, NOS
- Bacterial infection, NOS
- Fever or fever of unknown origin (FUO)
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
- Code the organism
- Others, as mentioned above.
Related CCI Codes
Data Integrity Checks (automatic list)
none found
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