VDRF

dallend@einstein.edu

How would you handle this:
Patient admitted to hospital with CVA - intubated for airway protection per progress note. No s/s respiratory failure. Extubated in less than 48 hrs.
We are having a discussion in house about VDRF vs acute/chronic resp failure.
Many of our physicians will documented VDRF for patients intubated for airway protection. If they do not we are being asked to query for this diagnosis as a means of capturing the dependence on the mech. vent.
I cannot find a coding clinic regarding this.
Any ideas!!
Thanks,
Debby Dallen,RN
Clinical documentation Coordinator

dog

You might want to look at these cites that I posted in a previous thread about MCCs. In my opinion, airway protection isn't the same as pulmonary insufficiency following trauma or surgery, which is what VDRF codes out to be.



"Postoperative respiratory failure was defined as mechanical ventilation for longer than 48 hours or unplanned reintubation."
--Multivariable predictors of postoperative respiratory failure after general and vascular surgery, RG Johnson, et.al, J Am Coll Surgeons June 2007

"Respiratory failure was defined as greater than 48 hours of ventilator assistance or postoperative reintubation."
--Postoperative mortality and pulmonary complication rankings: how well do they correlate at the hospital level, AM Arozullah, et.al, Medical Care, Vol 41, No 8

"...postoperative respiratory failure, usually defined as a requirement for mechanical ventilatory support for more than two days or a failed attempt at extubation."
--Preoperative Maneuvers to Avert Postoperative Respiratory Failure in Elderly Patients, D Gore, Gerontology, May 2008

Renee

Linda Renee Brown, RN, CCRN, CCDS
Clinical Documentation Specialist
Arizona Heart Hospital