Respiratory failure (insufficiency), chronic: Difference between revisions
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*Also code the cause if known. | *Also code the cause if known. | ||
*Also code '''[[Chronic dependence on mechanical ventilator]]''' if present. | *Also code '''[[Chronic dependence on mechanical ventilator]]''' if present. | ||
*Use this code for a patient who comes into | *Use this code for a patient who comes into ward or ICU from home or a chronic care facility or IICU, where respiratory insufficiency or failure has been present -- in this situation use this code as a [[Comorbid Diagnosis]]. | ||
**But if the patient comes to hospital with respiratory insufficiency or failure directly from any acute care facility where it FIRST developed (i.e. was not present prior to admission to that sending acute care facility) you do NOT use this code. This applies even if this is the third or fourth transfer during same episode of hospital care. | **But if the patient comes to hospital with respiratory insufficiency or failure directly from any acute care facility (other than IICU) where it FIRST developed (i.e. was not present prior to admission to that sending acute care facility) you do NOT use this code. This applies even if this is the third or fourth transfer during same episode of hospital care. | ||
*In general do NOT use this code for someone with no pre-existing chronic respiratory insufficiency/failure, who came into hospital with (or developed while in hospital) acute respiratory failure -- EXCEPT you can use this code when someone with acute respiratory failure '''evolves''' into chronic respiratory insufficiency/failure during their time in hospital, for which this code would be a '''[[Acquired Diagnosis / Complication]]'''. And the decision that this occurred will be a clinical decision, made by the data collectors. | *In general do NOT use this code for someone with no pre-existing chronic respiratory insufficiency/failure, who came into hospital with (or developed while in hospital) acute respiratory failure -- EXCEPT you can use this code when someone with acute respiratory failure '''evolves''' into chronic respiratory insufficiency/failure during their time in hospital, for which this code would be a '''[[Acquired Diagnosis / Complication]]'''. And the decision that this occurred will be a clinical decision, made by the data collectors. | ||
{{DiscussTask| This is the first time I am reading the WIKI on this code. It looks like this code should be used as a comorb on some of our patients. in the pre ICD 10 codes, we had COPD-mild, moderate or severe as Comorb options, with guidelines for when to use each. It would be helpful to have some "cut-off" guidelines for when to use this code, rather than having it be subjective. For example, if someone has chronic COPD now, I am simply coding it in the COMORB field as [[COPD, without exacerbation]], even if that patient is on home oxygen.}} | {{DiscussTask| This is the first time I am reading the WIKI on this code. It looks like this code should be used as a comorb on some of our patients. in the pre ICD 10 codes, we had COPD-mild, moderate or severe as Comorb options, with guidelines for when to use each. It would be helpful to have some "cut-off" guidelines for when to use this code, rather than having it be subjective. For example, if someone has chronic COPD now, I am simply coding it in the COMORB field as [[COPD, without exacerbation]], even if that patient is on home oxygen.}} | ||
Revision as of 15:04, 28 June 2020
| ICD10 Diagnosis | |
| Dx: | Respiratory failure (insufficiency), chronic |
| ICD10 code: | J96.19 |
| Pre-ICD10 counterpart: | none assigned |
| Charlson/ALERT Scale: | none |
| APACHE Como Component: | Respiratory |
| APACHE Acute Component: | none |
| Start Date: | |
| Stop Date: | |
| External ICD10 Documentation | |
This diagnosis is a part of ICD10 collection.
Additional Info
- Note that this code covers not just overt respiratory failure, but all levels of respiratory insufficiency.
- e.g. You can use it for a chronically hypercapnic COPD patient, or for a chronically hypoxemic pulmonary fibrosis patient, etc.
- This code would likely be the main admit diagnosis to IICU for a large number of patients going to that unit
- And furthermore, it's appropriate in the ICU record prior to IICU transfer to code it as an acquired diagnosis.
- Also code the cause if known.
- Also code Chronic dependence on mechanical ventilator if present.
- Use this code for a patient who comes into ward or ICU from home or a chronic care facility or IICU, where respiratory insufficiency or failure has been present -- in this situation use this code as a Comorbid Diagnosis.
- But if the patient comes to hospital with respiratory insufficiency or failure directly from any acute care facility (other than IICU) where it FIRST developed (i.e. was not present prior to admission to that sending acute care facility) you do NOT use this code. This applies even if this is the third or fourth transfer during same episode of hospital care.
- In general do NOT use this code for someone with no pre-existing chronic respiratory insufficiency/failure, who came into hospital with (or developed while in hospital) acute respiratory failure -- EXCEPT you can use this code when someone with acute respiratory failure evolves into chronic respiratory insufficiency/failure during their time in hospital, for which this code would be a Acquired Diagnosis / Complication. And the decision that this occurred will be a clinical decision, made by the data collectors.
|
This is the first time I am reading the WIKI on this code. It looks like this code should be used as a comorb on some of our patients. in the pre ICD 10 codes, we had COPD-mild, moderate or severe as Comorb options, with guidelines for when to use each. It would be helpful to have some "cut-off" guidelines for when to use this code, rather than having it be subjective. For example, if someone has chronic COPD now, I am simply coding it in the COMORB field as COPD, without exacerbation, even if that patient is on home oxygen. |
- For a typical IICU patient, use the following codes if applicable:
- Respiratory failure (insufficiency), chronic in admit codes. (If the patient came from another unit (ex.MICU) this code would be an acquired diagnosis in that profile).
- Code the underlying cause for the respiratory failure (ex. GBS, C-spine injury, etc).
- Muscle, wasting/atrophy NOS
- Tracheostomy, has one
Alternate ICD10s to consider coding instead or in addition
- Respiratory failure (insufficiency) NOS, acute
- Respiratory failure (insufficiency), chronic
- Respiratory failure (insufficiency) NOS, not specified as acute or chronic
- Chronic dependence on mechanical ventilator
- Hypercapnia (hypercarbia)
- Hypoxemia (hypoxia)
- ARDS (noncardiogenic pulmonary edema)
- Transfusion-related acute lung injury (TRALI, form of ARDS)
- Respiratory arrest
Candidate Combined ICD10 codes
Related CCI Codes
Data Integrity Checks (automatic list)
none found
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