Lower respiratory tract infection, acute infectious

ICD10 Diagnosis
Dx:	Lower respiratory tract infection, acute infectious
ICD10 code:	J22
Pre-ICD10 counterpart:	Tracheobronchitis
Charlson/ALERT Scale:	none
APACHE Como Component:	none
APACHE Acute Component:	2019-0: Respiratory Infection
Start Date:
Stop Date:
External ICD10 Documentation	ICD-10 CM Wikipedia ICD-10 Wikipedia WHO ICD10 documentation ICD10data.com

This diagnosis is a part of ICD10 collection.

• SMW
  • 2019-01-01
  • 2999-12-31
  • J22

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Additional Info

Includes ACUTE infectious:

1) Bronchitis -- inflammation of the bronchi, in this case due to infection

2) Bronchiolitis -- inflammation of the bronchioles (small, distal bronchi), in this case due to infection

• But it does not include Bronchiolitis obliterans organizing pneumonia (BOOP, cryptogenic organizing pneumonia (COP)), which is an immune-mediated, not infectious, entity

3) Tracheobronchitis,

• Any combination of #1, #2 and #3

• The could be confusion about what is "upper" vs. "lower" respiratory.
  • Remember from top to bottom, the anatomy is: oropharynx --> larynx --> trachea --> main carina --> bronchi --> smaller bronchi and then bronchioles --> alveoli.
  • For ICD10 coding, the answer is anything above and including the main carina at the bottom of the trachea is "upper" and everything below that is "lower". So, while a pure tracheitis or laryngitis is upper, a tracheobronchitis includes part of lower airway and thus is categorized as lower.

Excludes:

• PNEUMONIA
• Laryngitis or tracheitis, acute
• Upper respiratory infection, acute NOS

• Regarding chronic infections of lower respiratory tract:
  • For involvement limited to airways/bronchi, use one of:
    • Bronchitis, chronic, infectious or noninfectious
    • Bronchitis, acute or chronic not specified, infectious or noninfectious
  • For chronic alveolar infection (i.e. pneumonia) there is NOT a specific distinction in the codes between acute and chronic. HOWEVER, true chronic pneumonias are rare in immunocompetent patients unelss they're due to indolent bugs, such as certain fungi, parasites, and TB.

Alternate ICD10s to consider coding instead or in addition

• Bronchitis, acute or chronic not specified, infectious or noninfectious (lower respiratory problem)
• Bronchitis, chronic, infectious or noninfectious (lower respiratory problem)
• Disorder of upper respiratory tract, infectious or noninfectious NOS
• Upper respiratory infection, acute NOS

Lower respiratory tract infection codes:

Bronchitis, acute or chronic not specified, infectious or noninfectious Bronchitis, chronic, infectious or noninfectious

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)

	App	Status
Query check ICD10 Inf Infection req Pathogen must have one	CCMDB.accdb	implemented
Query Check Inf Pathogens must have Infection requiring pathogen or Potential Infection	CCMDB.accdb	implemented

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ICD10 Categories: ANCA-associated Vasculitis (AAV), Abdominal trauma, Abortion, Acute intoxication, Addiction, Adrenal Insufficiency, Adverse effect, Alcohol related, Allergy, Anemia, Anesthetic related, Aneurysm, Antibiotic resistance, Antidepressant related, Aortic Aneurysm, Arrhythmia, Arterial thromboembolism, Asthma, Atherosclerosis, Awaiting/delayed transfer, Bacteria, Benign neoplasm, Breast disease, Burn, COVID, Cannabis related, Cardiac septum problem, Cardiovascular, Cerebral Hemorrhage/Stroke, Chemical burn, Chronic kidney disease, Cirrhosis, Cocaine related, Decubitus ulcer, Delirium, Dementia, Diabetes, Diagnosis implying death, Double duty pathogen, ENT, Electrolyte disturbance, Encephalitis, Encephalopathy, Endocrine disorder, Endocrine neoplasm, Exposure, Eye, Female genital neoplasm, Fistula, Fracture, Fungus, GI ulcer, Gastroenteritis, Gastrointestinal, Gastrointestinal neoplasm, Hallucinogen related, Has one, Head trauma, Head trauma (old), Healthcare contact, Heart valve disease, Heme/immunology, Heme/immunology neoplasm, Hemophilia, Hemorrhage, Hepatitis, Hereditary/congenital, Hernia, Hypertension, Hypotension, Iatrogenic, Iatrogenic infection, Iatrogenic mechanism, Imaging, Infection requiring pathogen, Infection with implied pathogen, Infectious disease, Inflammatory Bowel Disease, Influenza, Inhalation, Intra-abdominal infection, Ischemia, Ischemic gut, Ischemic heart disease, Joint/ligament trauma, Leukemia, Liver disease, Liver failure, Lower limb trauma, Lower respiratory tract infection, Lymphoma, Male genital neoplasm, Mechanism, Meningitis, Metabolic/nutrition, Metastasis, Misc, Muscle problem, Muscles/tendon trauma, Musculoskeletal/soft tissue... further results