Bacteremia

ICD10 Diagnosis
Dx:	Bacteremia
ICD10 code:	A49.9
Pre-ICD10 counterpart:	Septicemia
Charlson/ALERT Scale:	none
APACHE Como Component:	none
APACHE Acute Component:	Neuro NOS
External ICD10 Documentation	ICD-10 CM Wikipedia ICD-10 Wikipedia WHO ICD10 documentation ICD10data.com

This diagnosis is a part of ICD10 collection.

Additional Info

• Bacteremia is a clearcut entity, which means bacteria circulating in the blood, and not due to contaminated blood culture. #Bacteremia is not a blind replacement for septicemia!
• NOTE: Bacteremia is a finding, not a specific disease. And even though the general rule is that coding findings/signs/symptoms is optional when the underlying cause is known, you should ALWAYS specifically code bactermia when present
  • Furthermore, at the discretion of the data collector, they can be coded as Combined ICD10 codes with another presumed infection (e.g. Klebsiella pneumonia with to Klebsiella bacteremia), but if it’s not completely clear that they’re related, code the bacteremia seperately as “free standing”.

what do you mean by free-standing? Do you mean not to use Combined ICD10 codes? Bacteremia is in Category:Infection requiring pathogen, so it has to be coded with a pathogen. Do you mean it should be coded with Infectious organism, unknown or similar? Ttenbergen 13:36, 2019 February 1 (CST);

Just to clarify: when a patient has septic shock and we put in the pathogen from a positive blood culture, do we also have to code bacteremia? OR is this code only for positive blood cultures where the source is not known?--LKolesar 14:20, 2019 February 12 (CST)

• • • If you include any of the sepsis codes AND you have bacteremia, then it's a clinical decision of whether or not to link those two codes. }}

Bacteremia is not a blind replacement for old septicemia dx!

The word "septicemia" is and always has been confusing, if not completely meaningless. It has been used both to mean pathogens in the blood (which is bacteremia or Fungemia, NOS), to mean toxic products of bugs in the blood (such as LPS or endotoxin which cause some of the clinical manifestations of Severe sepsis/Shock, septic), and to mean sepsis or Shock, septic. So going forward we don't need or want a replacement for that vague entity "septicemia".

Alternate ICD10s to consider coding instead or in addition

• Shock, septic
• Severe sepsis
• Sepsis (SIRS due to infection, without acute organ failure)
• Any infection that is the source of this bacteremia.
• Fungemia, NOS
• Bacterial infection, NOS
• Fever or fever of unknown origin (FUO)

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 Infections in ICD10 for more info.

Infection requiring pathogen

This diagnosis is an infection that requires a pathogen to be coded.

• Code the organism
• Others, as mentioned above.

Related CCI Codes

Data Integrity Checks (SMW)

	App	Status
Check Inf Pathogens must have Infection requiring pathogen or Potential Infection	CCMDB.mdb	implemented
Check Inf Infection requiring pathogen must have pathogen combined code	CCMDB.mdb	implemented

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