Iatrogenic, infection, urinary catheter: Difference between revisions
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| Line 26: | Line 26: | ||
** suprapubic catheter-related infection | ** suprapubic catheter-related infection | ||
** nephrostomy tube related infection | ** nephrostomy tube related infection | ||
**ureter stent infection | |||
*For an infected PD catheter see [[Iatrogenic, infection, internal prosthetic device or implant or graft NOS]] | *For an infected PD catheter see [[Iatrogenic, infection, internal prosthetic device or implant or graft NOS]] | ||
Revision as of 12:58, 29 February 2024
| ICD10 Diagnosis | |
| Dx: | Iatrogenic, infection, urinary catheter |
| ICD10 code: | T83.5 |
| Pre-ICD10 counterpart: | Pyelonephritis (Kidney Infection/Abcess), Cystitis (Bladder Infection) |
| Charlson/ALERT Scale: | none |
| APACHE Como Component: | none |
| APACHE Acute Component: | none |
| Start Date: | |
| Stop Date: | |
| External ICD10 Documentation | |
This diagnosis is a part of ICD10 collection.
Additional Info
Excludes:
- Includes :
- Foley infection
- suprapubic catheter-related infection
- nephrostomy tube related infection
- ureter stent infection
- For an infected PD catheter see Iatrogenic, infection, internal prosthetic device or implant or graft NOS
- Here is the CDC definition we will use:
- UTI where an indwelling urinary catheter was in place for >2 calendar days (or >48 hrs) as of the date the infection was identified as being present AND the catheter was in place on the day the infection was identified or the day before --- this latter phrase allows for diagnosing a urinary catheter-related infection the day after it was removed (but no later than that) if it had been in place >2 days or 48 hours prior to removal.
- This code identifies the mechanism of the infection, you must also code the infection (e.g. cystitis, pyelonephritis, etc)
- This code can be used as an Admit Diagnosis for someone admitted from outside the hospital with acute infection from an indwelling urinary catheter (i.e. the it can be iatrogenic even if it doesn't happen in hospital).
- This is one of a number of different types of iatrogenic injury codes. Here is information about all of them; Iatrogenic codes in ICD10
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
- Any of the other iatrogenic injury codes: see Iatrogenic codes in ICD10
- Hemoglobinuria
Candidate Combined ICD10 codes
- Kidney infection, acute (pyelonephritis)
- Kidney infection, chronic (pyelonephritis)
- Kidney, renal abscess or perinephric abscess
- Bladder, cystitis, acute infectious
- Bladder, cystitis, chronic
- Urethra, infectious or noninfectious urethritis
- Urinary tract infection, NOS
- Prostate, acute prostatitis
- Prostate, chronic prostatitis
- Prostate, abscess
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
Related CCI Codes
Data Integrity Checks (automatic list)
| App | Status | |
|---|---|---|
| Query check ICD10 Inf Infection req Pathogen must have one | CCMDB.accdb | implemented |
| Query Check Inf Pathogens must have Infection requiring pathogen or Potential Infection | CCMDB.accdb | implemented |
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