Iatrogenic, infection, cardiac or vascular prosthetic device or implant or graft NOS
|Dx:||Iatrogenic, infection, cardiac or vascular prosthetic device or implant or graft NOS|
|Pre-ICD10 counterpart:||Vasc. Graft Infection, Infected Graft Resection|
|APACHE Como Component:||none|
|APACHE Acute Component:||none|
|External ICD10 Documentation|
- Do not use this code for CVC bloodstream infection, that code is Iatrogenic, infection, central venous catheter-related bloodstream infection (CVC-BSI, CLI)
- This code includes skin and soft tissue infections due to any type of cardiac or vascular prosthetic device or implant or graft-- including both central lines and peripheral lines.
- So this is the code for infections related to vascular graft, pacemaker, defibrillator, balloon pump, IVC filter, VAD, A-V fistula/shunt.
- This is one of a number of different types of iatrogenic injury codes. Here is information about all of them; Iatrogenic codes in ICD10
- Some iatrogenic codes are self-explanatory for what occurred. For example Iatrogenic, air embolism, as complication of line/infusion/transfusion/injection. But for others, such as Iatrogenic, puncture or laceration, related to a procedure or surgery NOS it's not clear what happened, i.e. what was iatrogenically injured.
- In these latter cases, with just one exception, DO NOT also code a trauma code for what was iatrogenically injured. This is because iatrogenic injuries are technically not considered to be traumas.
- Instead, combine the iatrogenic code with another ICD10 code indicating the body part involved.
- e.g. for iatrogenic laceration of a pulmonary artery, combine: Iatrogenic, puncture or laceration, related to a procedure or surgery NOS with Disorder of pulmonary vessels, NOS.
- These are infections that are related to medical care
- Most (but not all) are directly related to a medical device that predisposes the patient to infection
- e.g: ETT, vascular catheters, Foley, suprapubic catheter, implanted ortho devices, implanted cardiac devices, etc, etc.
- For the following three we have specific diagnostic (and attributional) criteria:
- Also see Nosocomial infection, NOS
Regarding Attribution and Identification of Surgical Wound Infections
- Note that these iatrogenic infections are attributed to the perioperative care for 30 days --- and for ONE WHOLE YEAR if related to an implanted device left in place
- Our reference for this is this (specifically pages 9-10 to 9-14), and describes 4 entities:
- SUPERFICIAL INCISIONAL SURGICAL SITE INFECTION
- DEEP INCISIONAL SURGICAL SITE INFECTION
- ORGAN/SPACE SURGICAL SITE INFECTION -- without an implanted device left in place
- ORGAN/SPACE SURGICAL SITE INFECTION -- with an implanted device left in place
- For your purposes of whether such an infection is considered a Admit Diagnosis versus Acquired Diagnosis, use the timing rules as above
- Here is an unusual consequence of this rule for surgical wound infections: Patient has a hip prosthesis put in 8 months ago. Admitted 1 month ago with pneumonia, and today is recognized to have an infection of that hip prosthesis. Despite the fact that the hip infection "seems" to have occurred well after this hospital admission, by the CDC rule it is actually a ORGAN/SPACE SURGICAL SITE INFECTION, and therefore it is attributed to the surgery one year ago, and so you should code it as a Admit Diagnosis even though the recognition of it was delayed for a whole month while in hospital.
Alternate ICD10s to consider coding instead or in addition
- Iatrogenic, infection, central venous catheter-related bloodstream infection (CVC-BSI, CLI)
- Iatrogenic, infection, related to vascular access other than central line
- Iatrogenic, infection, heart valve prosthesis (incl prosthetic valve endocarditis)
- Iatrogenic, infection, following a procedure or surgery, NOS
- Any of the other iatrogenic injury codes: see Iatrogenic codes in ICD10
Candidate Combined ICD10 codes
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.
Infection requiring pathogen
This diagnosis is an infection that requires a pathogen to be coded.
Attribution of infections
- Include the organism.
Related CCI Codes
Data Integrity Checks (SMW)
|Check Inf Pathogens must have Infection requiring pathogen or Potential Infection||CCMDB.accdb||implemented|
|Query check ICD10 Inf Infection req Pathogen must have one||CCMDB.accdb||implemented|