Pneumonia Etiology not clear

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Category/Organ System:	Category: Infection (old)
Type:	Category: Medical Problem (old)
Main Diagnosis:	Pneumonia
Sub Diagnosis:	PNEUMONIA-Etiology not clear
Diagnosis Code:	3600
Comorbid Diagnosis:	No
Charlson Comorbid coding (pre ICD10):	0
Program:	CC & Med
Status:	Currently Collected

Discussion

• Why are collectors using 3659 in acquired complication slot? 3659 is aspiration pneumonia (where it occurred is not known). If it occurred after unit admission and is in the complication DX slots then it should be 3859 (Hospital acquired aspiration) should it not? --TOstryzniuk 11:50, 25 November 2009 (CST)
  • I agree that the pneumonia 3600-59 should only be used if you don't know on admission to your ward when the aspiration occured, after admission to your ward any pneumonia occuring would be HAP-aspiration.--Gail Hall.
  • I agree that if the pneumonia is in the acquired complications it should be coded as a HAP or VAP but I wouldn't mind clarification on when it is appropriate to use 59 (asp early presentation) as a subcode. Often the physician will write asp pneumonia because of decreased LOC or dysphagia as a cause. Is this how you would like us to use code 59? Or would like us to code HAP with either code 92 (culture not sent) or 65 (negative culture) or the actual organism that grows which ever is the case and not code 59 even if it appears the pt did aspirate due to decreased LOC?--MWaschuk 14:36, 26 November 2009 (CST)
  • This was explained. Please click on the link for more information: Aspiration (early presentation, documented aspiration).TOstryzniuk 14:42, 26 November 2009 (CST)