Resistance to antimicrobials, methicillin (anti-staph penicillins)

ICD10 Diagnosis
Dx:	Resistance to antimicrobials, methicillin (anti-staph penicillins)
ICD10 code:	U82.1
Pre-ICD10 counterpart:	ICD10 Guideline MRSA
Charlson/ALERT Scale:	none
APACHE Como Component:	none
APACHE Acute Component:	none
Start Date:
Stop Date:
External ICD10 Documentation	ICD-10 CM Wikipedia ICD-10 Wikipedia WHO ICD10 documentation ICD10data.com

This diagnosis is a part of ICD10 collection.

• SMW
  • 2019-01-01
  • 2999-12-31
  • U82.1

• Cargo

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• SMW

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• SMW

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Additional Info

• As of 2019, the way that the microbiology laboratory indicates in its reports that an organism is resistant to the antistaphlococcal penicillins (of which the architype is methicillin, hence the phrase "Methicillin-resistant staph aureus") is to specifically identify that it is resistant to oxacillin, with a comment that "MRSA has been isolated". It will NOT list any other of this class of drugs.

This is not a standard ICD10 code but a ICD10 CA code. We added it for the following reason: Antimicrobial resistance is not coded in standard ICD10. See Non-standard ICD10 Diagnoses for other codes like this.

List of Antimicrobials Relevant Here

Methicillin, nafcillin, oxacillin, cloxacillin, dicloxacillin, flucloxacillin [1]

Colonization

You can use the "set MRSA Colonized" button to enter the following:

• Combined code the following as a Comorbid Diagnosis (not as an Admit Diagnosis.
  • Staphylococcus aureus
  • Resistance to antimicrobials, methicillin (anti-staph penicillins)
  • Colonized with organism (not infected)
• Enter CCI Picklist Isolation, infectious, likely as Acquired Procedure, but consult Admit Procedure/Acquired Procedure to be sure.

Infection

Combined code the following

• the appropriate code from one of the following

• Staphylococcus aureus
• Resistance to antimicrobials, methicillin (anti-staph penicillins)

Colonized vs local infection

• If MRSA drawn from an abscess or deep in wound and you think it is causing the "local" infection, else code colonization.

Data Use

Julie reported in 2013 that in the past 2 years there were 2 requests for data related to these variables.

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

Antibiotic resistance

Antibiotic resistance is coded as Combined ICD10 codes of the condition/pathogen and the resistance. See Antibiotic Resistant Organism for more info.

Alternate ICD10s to consider coding instead or in addition

Candidate Combined ICD10 codes

• Colonized with organism (not infected)

Related CCI Codes

• Isolation, infectious

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ICD10 Categories: ANCA-associated Vasculitis (AAV), Abdominal trauma, Abortion, Acute intoxication, Addiction, Adrenal Insufficiency, Adverse effect, Alcohol related, Allergy, Anemia, Anesthetic related, Aneurysm, Antibiotic resistance, Antidepressant related, Aortic Aneurysm, Arrhythmia, Arterial thromboembolism, Asthma, Atherosclerosis, Awaiting/delayed transfer, Bacteria, Benign neoplasm, Breast disease, Burn, COVID, Cannabis related, Cardiac septum problem, Cardiovascular, Cerebral Hemorrhage/Stroke, Chemical burn, Chronic kidney disease, Cirrhosis, Cocaine related, Decubitus ulcer, Delirium, Dementia, Diabetes, Diagnosis implying death, Double duty pathogen, ENT, Encephalitis, Encephalopathy, Endocrine disorder, Endocrine neoplasm, Exposure, Eye, Female genital neoplasm, Fistula, Fracture, Fungus, GI ulcer, Gastroenteritis, Gastrointestinal, Gastrointestinal neoplasm, Hallucinogen related, Has one, Head trauma, Head trauma (old), Healthcare contact, Heart valve disease, Heme/immunology, Heme/immunology neoplasm, Hemophilia, Hemorrhage, Hepatitis, Hereditary/congenital, Hernia, Hypertension, Hypotension, Iatrogenic, Iatrogenic infection, Iatrogenic mechanism, Imaging, Infection requiring pathogen, Infection with implied pathogen, Infectious disease, Inflammatory Bowel Disease, Influenza, Inhalation, Intra-abdominal infection, Ischemia, Ischemic gut, Ischemic heart disease, Joint/ligament trauma, Leukemia, Liver disease, Liver failure, Lower limb trauma, Lower respiratory tract infection, Lymphoma, Male genital neoplasm, Mechanism, Meningitis, Metabolic/nutrition, Metastasis, Misc, Muscle problem, Muscles/tendon trauma, Musculoskeletal/soft tissue, Musculoskeletal/soft tissue neoplasm... further results