Infections in ICD10

Infections in ICD10 are coded somewhat inconsistently. There are #Diagnoses where the pathogen is implied and #Diagnoses where the pathogen must be coded separately. #Coding Antibiotic Resistance should also be done when there is one.

Which date to use for infections in Acquired Diagnosis / Complication

• The date we want to use is the date in which the infection first appeared clinically. This can be a very difficult determination, and may include consideration of:
  • Date on which the clinical signs or symptoms first appeared (e.g. fever, or dysuria, etc)
  • Date on which the culture was sent --- but this can be misleading because a culture may not be sent until several days after the symptoms appear.
  • Thus, as usual, you must use your clinical judgment to decide when the infection first showed up.

tangential questions

Untreated positive cultures, in general

• Probably the most common of these is urine and sputum.
• How to code these depends on what the clinical team thinks is true:
  • If they're not treating because they think it's NOT an infection and instead is colonization, then code it as one or the other of: Colonized with organism (not infected) and/or something like Urine tests, NOS, abnormal
  • If on the other hand, they just failed (permanently, or temporarily) to treat what became apparent later to be a real infection, then code it as an infection.

time restrictions around calling things iatrogenic

Iatrogenic Are all acquired treated UTI's (post 48 hours from admission) to be coded with an iatrogenic code? Is Iatrogenic, infection, urinary catheter coded if patient has one? The answer to this should probably go to Iatrogenic, infection, urinary catheter. AG REPLY -- Most infections related to medical devices or medical or surgical procedures have their own codes. When they don't or when a hosp-acquired infection doesn't have its own code, then use Nosocomial infection, NOS.

• SMW

• Cargo

• Categories

Coding Antibiotic Resistance

Antibiotic resistance is combined-coded, see Antibiotic Resistant Organism for more info.

Lab confirmation of results

See Pathogens#Culture reports

Data Integrity Checks (automatic list)

	App	Status
Query check ICD10 Inf Potential Infection must have pathogen or alt	CCMDB.accdb	declined
Check Inf Antibiotic resistance must have pathogen or Infection with implied pathogen	CCMDB.accdb	implemented
Check Inf Infection with implied pathogen must not have a pathogen combined code	CCMDB.accdb	implemented
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