Template:ICD10 Guideline Como vs Admit

This template is used in Comorbid Diagnosis and Admit Diagnosis to give consistent instructions when to use either or neither.

To use:

{{ICD10 Guideline Como vs Admit}}

Dx was present in the past but is not relevant to current admission
- Example: patient had appendix removed 7 years ago and is now admitted with injuries from a car accident; don't code the appendix removal at all.

Dx/Procedure happened prior to physical arrival in their bed on unit/ward
Template:Discussion See Px Type Should the Px Type = admit info/criteria found there be included/incorporated or a redirect added here?
Dx/Procedure is still relevant to the admission
Do not include old diagnoses that have been resolved.
- Example to code: patient admitted with a CAP to ICU who was intubated, ventilated and placed on antibiotics. They develop Atrial fibrillation and/or atrial flutter and are placed on meds which may need adjusting because they are still having breakthrough rapid Afib. Once extubated they are often ready for the medicine ward but are still on antibiotics for their CAP and require watching to see if their Afib returns. The medicine collector would list both CAP and Afib as part of their admitting diagnoses.
- Example not to code would be a patient with BPH who is not on any medications for it. They still have BPH but it is not an active problem being treated.

There is, in ICD10, a small list of codes that represent previous procedures or medical situations that can't be captured in another way.

Past medical history codes:
Artificial opening NOS, has one Cardiac pacemaker or defibrillator, has one Gastrostomy, has one Heart assist device, has one Past history of Chimeric Antigen Receptor T-cell Immunotherapy (CAR-T) Past history of chemotherapy for neoplastic disease Past history of immunosuppressive drugs or corticosteroids Past history of radiation therapy Past history, bone marrow or stem cell transplant Past history, cancer (any type), believed cured Past history, coronary revascularization Past history, heart valve replacement (any valve) Past history, loss of limb(s) Past history, myocardial infarction (old MI) Past history, organ/tissue transplant NOS Past history, removal of all or part of lung Past history, removal of any part of digestive tract Past history, removal of breast (mastectomy) Past history, removal of kidney (nephrectomy, partial or total) Past history, removal of organ NOS Past history, self-harm, suicide attempt Past history, thromboembolic disease (DVT or PE), now gone Past history, transplanted heart Past history, transplanted kidney Past history, transplanted liver Past history, transplanted lung(s) Past history, transplanted pancreas or islet cells Past history, tuberculosis, believed cured or inactive Suprapubic catheter, indwelling, has one Tracheostomy, has one

Many ICD10 diagnosis code can be used as a comorbid/pre-existing diagnosis -- the general criterion is that it was present PRIOR to admission

AND is still present and clinically relevant. Template:DiscussAllan

- If the diagnosis under consideration qualifies as an Admit Diagnosis, then in general it is not appropriate to code it as a comorbidity.
- If the diagnosis is acute then in general it is not appropriate to code it as a comorbidity.
Code these even if the diagnosis of the condition was only made during the current hospital admission but it is quite clear that it must have existed before admission (even if that wasn't known).
- Example 1: If a patient is admitted with pneumonia and on further workup is found to have CA of the lung, then this is coded in comorbid as it is obvious that the cancer must have been there for a while prior to admission.
- Example 2: Patient comes in with abdominal pain. Diagnosed as gastroenteritis but incidentally pt is found to be HIV +ve. You would code HIV +ve as a comorbid. Again, this is obvious that the pt had this problem for a while prior to admission to the hospital.

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