Iatrogenic, infection, urinary catheter

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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
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
    • T83.5
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Additional Info

Excludes:

  • 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

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

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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