Septicemia/Bacteremia/Fungemia

Dr Kumar We need your input on the following questions. Thanks kindly. Question;

1. When a patient has been admitted with urosepsis as an example, and has been determined by the physician to be septicemic and has received antibiotics before the blood cultures have been drawn and thereby affecting the results showing negative culture. Coding criteria for septicemia on page 10 of diagnosis code book is defined as "positive blood cultures".
2. Also, physician are recording the diagnosis of septicemia even when blood cultures are negative (negative cultures even with no antibiotics given pre blood cultures draw).
   • How do you want these patients captured?? Is capturing cystitis with a bug, if found, adequate and septicemia should NOT be coded, or use code septicemia and subcode as “culture negative” if physician is calling it septicemia?
   • If physician records the diagnosis of septicemia and that is their working diagnosis without a positive culture, do we code as septicemia subcode “negative culture”?
3. A similar question in regards to the definitions for severe sepsis, and septic shock if applicable. We have seen people who NOT meet all the criteria, yet they are exhibiting signs of either severe sepsis, or septic shock, and that is what the Dr. has diagnosed and is treating..--JHutton 11:13, 25 June 2008 (CDT)..--JHutton 11:13, 25 June 2008 (CDT)TOstryzniuk 11:59, 25 June 2008 (CDT)

• • reminder that Dr. Kumar has not yet responded to this question, and eagerly awaiting resolution.--JHutton 10:02, 29 October 2008 (CDT)