|Pre-ICD10 counterpart:||Pneumonitis 2nd Chemical Aspiration, Other respiratory problems|
|APACHE Como Component:||none|
|APACHE Acute Component:||2019-0: Aspiration/poisonings/toxic|
|External ICD10 Documentation|
This diagnosis is a part of ICD10 collection.
- if a patient aspirates due to decreased LOC use this code
- To code aspiration of tube feed due to improper feeding tube placement, use this code with Iatrogenic, complication of medical or surgical care NOS
- if a patient aspirates during a procedure such as intubation use this code and Failed/difficult intubation, or complication of intubation and Iatrogenic problem NOS, related to a surgery or procedure, NOS
- Despite its name, this entity is NOT an infection. It is fundamentally a chemical pneumonitis, which CAN become secondarily superinfected.
- If an actual lung infection (pneumonia) co-exists with it, you must use this code and a category:pneumonia code as Combined ICD10 codes.
- The reason people often (incorrectly) call it a "aspiration pneumonia" is that a chemical or food aspiration (noninfectious) often has ALL 3 of the cardinal signs of pneumonia: new infiltrate, fever, leukocytosis -- but in the case of aspiration, those manifestations are actually due to chemical irritation (e.g. the hydrochloric acid in the stomach) of the lung.
- Indeed, though it is very often done, the use of antibiotics to "treat" an aspiration in the early phases when it's almost certainly NOT infected, is not recommended.
Determining if an aspiration becomes secondarily infected
Here are some thoughts about how to figure out whether or not an aspiration event becomes secondarily infected:
The usual time course after the aspiration, of development of the lung inflammation and signs related to it, is typically hours to a day or more. And it is considered distinctly RARE for an actual infection due to an aspiration event to develop that quickly.
The usual time course of starting to see movement towards resolution of the signs of lung inflammation from noninfected aspiration pneumonitis, in the absence of secondary infection, is a few days. So, when a person who aspirates and is appropriately NOT given antibiotics starts to improve substantially within a few days, we take that as clinical confirmation that it wasn't infected.
On the other hand, the most clearcut kind of clinical evidence for secondary infection of a noninfectious aspiration pneumonitis is when the person starts to get better, and then after several days starts to get worse again.
The hardest situation in which to determine if a secondary infection has occurred, and whether to start antibiotics, is when the signs of lung inflammation (infiltrate, fever, leukocytosis) doesn't improves and remains bad or worsens.
When substances other than air are inhaled they can cause various problems; if one is present, others might be.
Alternate ICD10s to consider coding instead or in addition
- Hypersensitivity pneumonitis (extrinsic allergic alveoliltis), NOS
- Radiation pneumonitis (acute or chronic)
Candidate Combined ICD10 codes
- Code associated pneumonia, if it's superimposed on the aspiration.
Related CCI Codes
Data Integrity Checks (automatic list)