Iatrogenic, infection, heart valve prosthesis (incl prosthetic valve endocarditis): Difference between revisions

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{{ICD10 transition status
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| OldDxArticle =Endocarditis-Prosthetic Valve, Septic Prosthetic Device|  
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{{ICD10 category|heart valve disease}} {{ICD10 category|Cardiovascular}} {{ICD10 category|Infectious disease}}{{ICD10 category|Infection requiring pathogen}}{{ICD10 category|Iatrogenic}}{{ICD10 category|Iatrogenic infection}} {{ICD10 category|Misc}}  
{{ICD10 category|heart valve disease}}{{ICD10 category|Cardiovascular}}{{ICD10 category|Infectious disease}}{{ICD10 category|Infection requiring pathogen}}{{ICD10 category|Iatrogenic}}{{ICD10 category|Iatrogenic infection}}{{ICD10 category|Misc}}  


== Additional Info ==
== Additional Info ==
*This is one of a number of different types of iatrogenic injury codes. Here is information about all of them;  [[Iatrogenic codes in ICD10]]
In ICD10 prosthetic valve endocarditis is routinely coded as being an iatrogenic infection, regardless of the initiating cause (e.g. Intravenous Drug Abusers (IVDA)). In this context, it is "iatrogenic" because the prosthetic valve was a healthcare intervention, and made them more susceptible to the infection they picked up through their drug use.


{{Discuss | who = Allan | question = |
{{ICD10 Guideline heart valve disease}}
* In our old database we had an endocarditis code that could identify native valve vs prosthetic valve endocarditis.  I notice in ICD 10 we have [[Endocarditis, infective, acute or subacute]]  but the only code to identify that it is a prosthetic valve infection is this code.  I do not see this infection as "Iatrogenic" in all cases because often these infections are not caused by the health care they are given.  These infections often occur in the community for various reasons but would they always be iatrogenic just because the valve is artificial?  Just wondering if using this code in the context I am describing is OK?--[[User:LKolesar|LKolesar]] 11:14, 2018 March 28 (CDT)
 
** Would combined-coding with [[Past history, heart valve replacement (any valve)]] solve it? Ttenbergen 16:46, 2018 April 2 (CDT)
{{ICD10 Guideline Iatrogenic}}
** There is no code for the specific valve replaced (aortic, mitral, tricuspid).  Also, the infection may or may not be iatrogenic even when there is a history of valve replacement.--[[User:LKolesar|LKolesar]] 13:02, 2018 August 9 (CDT)}}


== Alternate ICD10s to consider coding instead or in addition ==
== Alternate ICD10s to consider coding instead or in addition ==
{{ListICD10Category | categoryName = heart valve disease}}
{{ListICD10Category | categoryName = heart valve disease}}
*Any of the other iatrogenic injury codes:  see [[Iatrogenic codes in ICD10]]
{{ListICD10Category | categoryName = Iatrogenic}}


== Candidate [[Combined ICD10 codes]] ==
== Candidate [[Combined ICD10 codes]] ==
[[Past history, heart valve replacement (any valve)]]
*[[Mitral valve disorder, NOS]]
 
*[[Aortic valve disorder, NOS]]
*[[Tricuspid valve disorder, NOS]]
*[[Pulmonary valve disorder, NOS]]
*[[Past history, heart valve replacement (any valve)]]
{{ICD10 Guideline Infection}}
{{ICD10 Guideline Infection}}


== Related CCI Codes ==
== Related CCI Codes ==
{{Data Integrity Check List}}


== Related Articles ==
== Related Articles ==
{{Related Articles}}
{{Related Articles}}


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{{ICD10 footer}}
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Latest revision as of 16:16, 2018 December 18

ICD10 Diagnosis
Dx: Iatrogenic, infection, heart valve prosthesis (incl prosthetic valve endocarditis)
ICD10 code: T82.6
Pre-ICD10 counterpart: Endocarditis-Prosthetic Valve, Septic Prosthetic Device
Charlson/ALERT Scale: none
APACHE Como Component: none
APACHE Acute Component: none
Start Date:
Stop Date:
External ICD10 Documentation

This diagnosis is a part of ICD10 collection.

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    • 2019-01-01
    • 2999-12-31
    • T82.6
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Additional Info

In ICD10 prosthetic valve endocarditis is routinely coded as being an iatrogenic infection, regardless of the initiating cause (e.g. Intravenous Drug Abusers (IVDA)). In this context, it is "iatrogenic" because the prosthetic valve was a healthcare intervention, and made them more susceptible to the infection they picked up through their drug use.

Heart valve disease coding guideline

Iatrogenic injuries

Iatrogenic Infection

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

heart valve disease codes:
Iatrogenic 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

See Attribution of infections


Related CCI Codes

Data Integrity Checks (automatic list)

 AppStatus
Query check ICD10 Inf Infection req Pathogen must have oneCCMDB.accdbimplemented
Query Check Inf Pathogens must have Infection requiring pathogen or Potential InfectionCCMDB.accdbimplemented

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