Nosocomial infection, NOS

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ICD10 Diagnosis
Dx: Nosocomial infection, NOS
ICD10 code: Y95
Pre-ICD10 counterpart: none assigned
Charlson/ALERT Scale: none
APACHE Como Component: none
APACHE Acute Component: none
Start Date: 2018-12-20
External ICD10 Documentation
This diagnosis is a part of ICD10 collection.

Additional Info

  • Nosocomial means hospital-acquired.
  • This code is for hospital-acquired infections that don't have their own more specific code.
    • Most nosocomial infections are related to medical devices (e.g. Foley) or occur in relation to a medical or surgical procedure (e.g. postop wound infection). For those, seek a more specific code (likely in Iatrogenic infection before you default to this more general one.
  • To qualify as a nosocomial infection, the first evidence (even looking backward in time) of its presence must have been >48 hours after admission.
  • Since this code doesn't indicate what is infected, it should be combined with the code for which infection, e.g. for a non-Foley related nosocomial UTI that occurred 96 hours after admission, combine this code with Urinary tract infection, NOS

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

Iatrogenic infection codes:

Candidate Combined ICD10 codes

Related CCI Codes

Data Integrity Checks (SMW)

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

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