Hospital-acquired pneumonia (HAP) in ICD10

This page contains an ICD10 Coding Guideline for ICD10 collection. See ICD10 coding guidelines for similar pages.

This page explains how to code Hospital Acquired Pneumonia (HAP) in ICD10. Hospital-acquired pneumonia (HAP) is a type of nosocomial pneumonia that is contracted by a non-ventilated patient after at least 48 hours of being admitted to a hospital.

Coding instructions

• HAP is indicated by combined coding three separate ICD10 codes:
  • (1) Iatrogenic, complication of medical or surgical care NOS PLUS
  • (2) One of the codes for specific types of organisms:
    • Pneumonia, bacterial
    • Pneumonia, fungal/yeast
    • Pneumonia, viral
    • Pneumonia, NOS
  • (3) relevant Pathogens, possibly Infectious organism, unknown or an NOS

Alternate ICD10s to consider coding instead or in addition

• Pneumonia, ventilator-associated (VAP)
• Community-acquired pneumonia (CAP) in ICD10

Additional Info

• If there is insufficient criteria for a Pneumonia, ventilator-associated (VAP) in ventilated patients with positive cultures, the patient may still have HAP.
• Patients from Grace Nursing Home Ward - even though this is considered a nursing home type ward, for patients who acquire a pneumonia and meet the HAP criteria code HAP.

Questions

• Can we have some direction on early onset HAP? For example if a patient comes into hospital doesn't have an infiltrate on CXR or signs of pneumonia (ie in hospital for something else)and on day 2 of admission gets intubated and aspirates during intubation. The secretions grow pathogens on the day of intubation but the infiltrate doesn't show up until day 4. Do you call this HAP or CAP?
• Can we define early onset versus late onset HAP and VAP?