Lower respiratory tract infection, acute infectious
| ICD10 Diagnosis | |
| Dx: | Lower respiratory tract infection, acute infectious |
| ICD10 code: | J22 |
| Pre-ICD10 counterpart: | Tracheobronchitis |
| Charlson/ALERT Scale: | none |
| APACHE Como Component: | none |
| APACHE Acute Component: | 2019-0: Respiratory Infection |
| Start Date: | |
| Stop Date: | |
| External ICD10 Documentation | |
This diagnosis is a part of ICD10 collection.
Additional Info
Includes ACUTE infectious:
- 1) Bronchitis -- inflammation of the bronchi, in this case due to infection
- 2) Bronchiolitis -- inflammation of the bronchioles (small, distal bronchi), in this case due to infection
- But it does not include Bronchiolitis obliterans organizing pneumonia (BOOP, cryptogenic organizing pneumonia (COP)), which is an immune-mediated, not infectious, entity
- 3) Tracheobronchitis,
- Any combination of #1, #2 and #3
- The could be confusion about what is "upper" vs. "lower" respiratory.
- Remember from top to bottom, the anatomy is: oropharynx --> larynx --> trachea --> main carina --> bronchi --> smaller bronchi and then bronchioles --> alveoli.
- For ICD10 coding, the answer is anything above and including the main carina at the bottom of the trachea is "upper" and everything below that is "lower". So, while a pure tracheitis or laryngitis is upper, a tracheobronchitis includes part of lower airway and thus is categorized as lower.
Excludes:
- Regarding chronic infections of lower respiratory tract:
- For involvement limited to airways/bronchi, use one of:
- For chronic alveolar infection (i.e. pneumonia) there is NOT a specific distinction in the codes between acute and chronic. HOWEVER, true chronic pneumonias are rare in immunocompetent patients unelss they're due to indolent bugs, such as certain fungi, parasites, and TB.
Alternate ICD10s to consider coding instead or in addition
- Bronchitis, acute or chronic not specified, infectious or noninfectious (lower respiratory problem)
- Bronchitis, chronic, infectious or noninfectious (lower respiratory problem)
- Disorder of upper respiratory tract, infectious or noninfectious NOS
- Upper respiratory infection, acute NOS
| pneumonia codes: |
| Lower respiratory tract infection codes: |
Candidate Combined ICD10 codes
Infections
Infections in ICD10 have combined coding requirements for some of their pathogens. Any that have antibiotic resistances would store those as Combined ICD10 codes as well. If the infection is acquired in the hospital, see Nosocomial infection, NOS. See Lab and culture reports for confirmation and details about tests. See Infections in ICD10 for more general info.
Possible Simultaneous Presence of Multiple Different Types of Infection in a Single Site
- This refers to the situation where there may be simultaneous infection with multiple types of organisms -- e.g. 2 of bacteria, virus, fungus. While a classic example is a proven viral pneumonia (e.g. influenza) with a suspected/possible bacterial pneumonia superimposed, this kind of thing can occur in places other than the lungs, e.g. meningitis.
- The "signature" of this is typically the patient being treated simultaneously with antimicrobial agents for multiple types of organisms. BUT don't confuse this with there being infections at DIFFERENT body sites.
- As per our usual practice, we will consider a diagnosis as present if the clinical team thinks it's present and are treating it, with the exception that the team initially treated for the possible 2nd type of infection but then decided it likely was NOT present and stopped those agents.
- And remember that Infectious organism, unknown is used when the the specific organism is unknown (this could be not knowing the TYPE of organism, or suspecting the type but not having identified the specific organism of that type), while when the organism has been identified but it's not in our bug list, THEN use Bacteria, NOS, Virus, NOS or Fungus or yeast, NOS.
Attribution of infections
Related CCI Codes
Data Integrity Checks (automatic list)
| App | Status | |
|---|---|---|
| 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 |
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