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.

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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