Nosocomial infection, NOS: Difference between revisions
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*To qualify as a nosocomial infection, the first evidence (even looking backward in time) of its presence must have been '''>48 hours after admission'''. | *To qualify as a nosocomial infection, the first evidence (even looking backward in time) of its presence must have been '''>48 hours after admission'''. | ||
*Since this code doesn't indicate what is infected, it should be combined with the code for which infection, e.g. for a non-[[Foley]] related nosocomial UTI that occurred 96 hours after admission, combine this code with '''[[Urinary tract infection, NOS]]''' | *Since this code doesn't indicate what is infected, it should be combined with the code for which infection, e.g. for a non-[[Foley]] related nosocomial UTI that occurred 96 hours after admission, combine this code with '''[[Urinary tract infection, NOS]]''' | ||
===Coding Nosocomial infection with an infection with an implied pathogen=== | |||
* If you have a patient that has a nosocomial infection and that nosocomial infection is an infection with an implied pathogen, code both as separate [[Acquired Diagnosis]] with separate priorities. for eg. (1) Influenza pneumonia (which has an implied organism) and (2) Nosocomial infection, NOS with the organism being Influenza virus NOS -- should almost never be used. | |||
* see also [[:Category:Infection with implied pathogen|Infection with implied pathogen]] | |||
{{ICD10 Guideline Iatrogenic}} | {{ICD10 Guideline Iatrogenic}} | ||
Latest revision as of 19:04, 10 December 2023
| ICD10 Diagnosis | |
| Dx: | Nosocomial infection, NOS |
| ICD10 code: | Y95 |
| Pre-ICD10 counterpart: | none assigned |
| Charlson/ALERT Scale: | none |
| APACHE Como Component: | none |
| APACHE Acute Component: | none |
| Start Date: | 2018-12-20 |
| Stop Date: | |
| Data Dependencies(Reports/Indicators/Data Elements): | No results |
| External ICD10 Documentation | |
This diagnosis is a part of ICD10 collection.
Additional Info
- Nosocomial means hospital-acquired.
- This code is for hospital-acquired infections that don't have their own more specific code.
- Most nosocomial infections are related to medical devices (e.g. Foley) or occur in relation to a medical or surgical procedure (e.g. postop wound infection). For those, seek a more specific code (likely in Iatrogenic infection before you default to this more general one.
- To qualify as a nosocomial infection, the first evidence (even looking backward in time) of its presence must have been >48 hours after admission.
- Since this code doesn't indicate what is infected, it should be combined with the code for which infection, e.g. for a non-Foley related nosocomial UTI that occurred 96 hours after admission, combine this code with Urinary tract infection, NOS
Coding Nosocomial infection with an infection with an implied pathogen
- If you have a patient that has a nosocomial infection and that nosocomial infection is an infection with an implied pathogen, code both as separate Acquired Diagnosis with separate priorities. for eg. (1) Influenza pneumonia (which has an implied organism) and (2) Nosocomial infection, NOS with the organism being Influenza virus NOS -- should almost never be used.
- see also Infection with implied pathogen
Iatrogenic injuries
- Some iatrogenic codes are self-explanatory for what occurred. For example Iatrogenic, air embolism, as complication of line/infusion/transfusion/injection. But for others, such as Iatrogenic, puncture or laceration, related to a procedure or surgery NOS it's not clear what happened, i.e. what was iatrogenically injured.
- In these latter cases, with just one exception, DO NOT also code a trauma code for what was iatrogenically injured. This is because iatrogenic injuries are technically not considered to be traumas.
- that one exception is you should code Rib fracture(s) due to CPR in the context of CPR, cardiac resuscitation.
- Instead, combine the iatrogenic code with another ICD10 code indicating the body part involved.
- e.g. for iatrogenic laceration of a pulmonary artery, combine: Iatrogenic, puncture or laceration, related to a procedure or surgery NOS with Disorder of pulmonary vessels, NOS. See list of NOS codes in ICD10.
- In these latter cases, with just one exception, DO NOT also code a trauma code for what was iatrogenically injured. This is because iatrogenic injuries are technically not considered to be traumas.
Iatrogenic Infection
- These are infections that are related to medical care
- Most (but not all) are directly related to a medical device that predisposes the patient to infection
- e.g: ETT, vascular catheters, Foley, suprapubic catheter, implanted ortho devices, implanted cardiac devices, etc, etc.
- For the following three we have specific diagnostic (and attributional) criteria:
- Also see Nosocomial infection, NOS
Regarding Attribution and Identification of Surgical Wound Infections
- Note that these iatrogenic infections are attributed to the perioperative care for 30 days --- and for ONE WHOLE YEAR if related to an implanted device left in place
- Our reference for this is this (specifically pages 9-10 to 9-14), and describes 4 entities:
- SUPERFICIAL INCISIONAL SURGICAL SITE INFECTION
- DEEP INCISIONAL SURGICAL SITE INFECTION
- ORGAN/SPACE SURGICAL SITE INFECTION -- without an implanted device left in place
- ORGAN/SPACE SURGICAL SITE INFECTION -- with an implanted device left in place
- For your purposes of whether such an infection is considered a Admit Diagnosis versus Acquired Diagnosis, use the timing rules as above
- Here is an unusual consequence of this rule for surgical wound infections: Patient has a hip prosthesis put in 8 months ago. Admitted 1 month ago with pneumonia, and today is recognized to have an infection of that hip prosthesis. Despite the fact that the hip infection "seems" to have occurred well after this hospital admission, by the CDC rule it is actually a ORGAN/SPACE SURGICAL SITE INFECTION, and therefore it is attributed to the surgery one year ago, and so you should code it as a Admit Diagnosis even though the recognition of it was delayed for a whole month while in hospital.
Alternate ICD10s to consider coding instead or in addition
| Iatrogenic infection codes: |
Candidate Combined ICD10 codes
Related CCI Codes
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none found
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