Template:ICD10 Recent Previous Pneumonia

This template provides guidance on how to code any type of pneumonia

To use: {{ICD10 Recent Previous Pneumonia}}

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Guidelines for Recent Previous Pneumonia

• We have been reviewing our adjudication of VAP's using the CDC criteria. As a result we have tweaked some of our definitions and rules surrounding the coding of a PNA

• An important CDC guideline is that if a pneumonia episode of any type is adjudicated to be present, then at least 14 days must pass from its onset before another/different pneumonia (ie. VAP or HAP) can be identified as being present.
  • This holds even if the pathogens are different
  • This holds even if chest imaging shows infiltrates in different areas of the lungs
  • A relevant manifestation of this is if a patient is admitted with a pneumonia (so it's a CAP), and is intubated, the earliest a VAP may occur is on hospital day#14.

• If a patient had any pneumonia previously during the same admission and then develops pneumonia again, meeting the VAP criteria, it is only a VAP if:
  • (i) onset was at least 14 days after onset of the previous pneumonia, and
  • (ii) it is a new organism and has new and persistent or progressive and persistent infiltrates. If it is the same original organism, then the pneumonia has not completely been resolved, and you should NOT code it as a VAP.

For example - A patient is admitted with Strep pneumoniae pneumonia and intubated. On hospital day #7 while intubated, there are clinical features of pneumonia and E. coli is cultured. This would be a single pneumonia episode with 2 pathogens - S. pneumoniae and E. coli.