Iatrogenic, infection, urinary catheter

ICD10 Diagnosis
Dx:	Iatrogenic, infection, urinary catheter
ICD10 code:	T83.5
Pre-ICD10 counterpart:	Pyelonephritis (Kidney Infection/Abcess), Cystitis (Bladder Infection)
Charlson/ALERT Scale:	none
APACHE Como Component:	none
APACHE Acute Component:	none
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

Excludes:

• Iatrogenic, mechanical complication/dysfunction, urinary catheter

• Includes
  • Foley infection
  • suprapubic catheter-related infection
  • nephrostomy tube related infection

• Here is the CDC definition we will use:
  • UTI where an indwelling urinary catheter was in place for >2 calendar days (or >48 hrs) as of the date the infection was identified as being present AND the catheter was in place on the day the infection was identified or the day before --- this latter phrase allows for diagnosing a urinary catheter-related infection the day after it was removed (but no later than that) if it had been in place >2 days or 48 hours prior to removal.

• This code identifies the mechanism of the infection, you must also code the infection (e.g. cystitis, pyelonephritis, etc)

• This code can be used as an Admit Diagnosis for someone admitted from outside the hospital with acute infection from an indwelling urinary catheter (i.e. the it can be iatrogenic even if it doesn't happen in hospital).

• This is one of a number of different types of iatrogenic injury codes. Here is information about all of them; Iatrogenic codes in ICD10

Iatrogenic injuries

• 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.
    • that one exception is you should code [[Rib fracture(s) due to CPR]] in the context of CPR, cardiac resuscitation.
  • 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.

Iatrogenic Infection

• 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:
  • VAP
  • Iatrogenic, infection, central venous catheter-related bloodstream infection (CVC-BSI, CLI)
  • Iatrogenic, infection, urinary catheter
• 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

• Any of the other iatrogenic injury codes: see Iatrogenic codes in ICD10
• Hemoglobinuria

Candidate Combined ICD10 codes

• Kidney infection, acute (pyelonephritis)
• Kidney infection, chronic (pyelonephritis)
• Kidney, renal abscess or perinephric abscess
• Bladder, cystitis, acute infectious
• Bladder, cystitis, chronic
• Urethra, infectious or noninfectious urethritis
• Urinary tract infection, NOS
• Prostate, acute prostatitis
• Prostate, chronic prostatitis
• Prostate, abscess

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.

Infection requiring pathogen

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

Attribution of infections

See Attribution of infections

Related CCI Codes

Data Integrity Checks (SMW)

	App	Status
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

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