UTI due to I/O cath

dwalker2dwalker2
in CDI Talk Archive
Hopefully this is an easy one....

Does a UTI due to I/O cath code to 996.65 (which then does to DRG 698) or since it is not indwelling/nephrostomy/urostomy issue does it code to simple UTI (DRG 689)?

Our facility has been coding this to simple UTI for more than 2 1/2 years (because that is what CDI was taught when the program started) and now all of a sudden I am being told by one of our long time coders that is should be the complication code.

Without any new coding clinics that speak specifically to I/O caths I am just confused on the sudden change.

Thanks in advance!

Dana Walker, RN CDS
Alamance Regional Medical Center

Comments

  • lsipos@monument.healthlsipos@monument.health
    edited May 2016
    IS A COMPLICATION CODE..CORRECT 99665

    Juli Bovard RN
    Regional Health
    Rapid City, SD 57703

  • lsipos@monument.healthlsipos@monument.health
    edited May 2016
    I/o cath...are you talking about a straight cath??

    Juli

  • ddouthitddouthit
    edited May 2016
    Dana,

    996.65 Infection and inflammatory reaction due to other genitourinary device/implant/graft.

    996.64 if for UTI secondary to indwelling foley catheter.

    I believe that a i/o cath would definitely fall under other genitourinary device thus a 996.65 would be appropriate.

    There is not a cc that speaks directly to this.

    Dorie Douthit, RHIT,CCS

  • dvitalone1dvitalone1
    edited May 2016
    Is an I/O cath similar to a Texas cath? It resembles a condom with adhesive? IF so would 996.65 or 996.64 be correct?


  • dwalker2dwalker2
    edited May 2016
    Yes, the I/O cath is a straight cath.

    Thanks for the prompt feedback!

    Dana

  • lprescottlprescott
    I was always taught yes this is complication of device code. for every UTI admission we look to see if there is a possible relationship to a cath and query if indicated.
    Laurie L. prescott RN, MSN, CCDS
  • angelamckee@uh.organgelamckee@uh.org
    edited May 2016
    I have to step in with my coding/auditing background. This is not a complication code.  996.6x codes only apply to internal prosthetic devices.    Although electronic coding (3M, etc) does not tell you that the code book does. The device must be indwelling. A straight cath or in/out cath is notan internal prosthetic device. Code 996.64 is for use of UTI due to indwelling urinary catheters. Code 996.65 is for use of other indwelling genitourinarydevices such as IUDs.  Thank you,

    Angie McKee, RHIT, CCDS, CCS, CCS-P
    AHIMA Approved ICD 10 Trainer
    Clinical Documentation Specialist
    Performance Improvementangelamckee@uh.org
    University Hospital
    1350 Walton Way,
    Augusta, Ga 30901

  • sharon.colesharon.cole
    edited May 2016
    Here's a coding clinic on that issue:
    AHA Coding Clinic(r) for ICD-9-CM, 1Q 2012, Volume 29, Number 1, Pages 11&12

    Question:
    A 50-year-old patient was recently discharged from the hospital with a diagnosis of sepsis due to a urinary source. Since being discharged, she has developed further nausea, vomiting, dysuria, fever, foul-smelling urine, and abdominal pain and was readmitted for management of her condition. The patient is status post colostomy and urostomy and the provider's final diagnostic statement indicated sepsis secondary to urinary source (i.e., urinary tract infection). The provider was queried whether the patient's urinary tract infection (UTI) was related to the urostomy. The provider documented "UTI due to poor self-catheterization technique/hygiene, status post urostomy." How should a urostomy associated UTI due to poor self-catheterization technique/hygiene be coded? Is code 996.64, Infection and inflammatory reaction due to internal prosthetic device, implant and graft, due to indwelling urinary catheter, appropriate?
    Answer:
    Assign code 997.5, Urinary complications, for the urostomy associated UTI, resulting from poor self-catheterization technique/hygiene. This code includes conditions associated with an external stoma of the urinary tract. Assign also code 599.0, Urinary tract infection, site not specified. The POA indicator of "Y" will clarify that the condition was present on admission, and is not hospital acquired. Additionally, code 996.64, Infection and inflammatory reaction due to internal prosthetic device, implant and graft, due to indwelling urinary catheter, is not appropriate since a urostomy is not an indwelling catheter. A urostomy is a surgically created opening in the abdominal wall that redirects urine and allows it to flow to the outside of the body.


    Sharon Cole, RN, CCDS
    Providence Health Center
    Case Management Dept
    254.751.4256
    Sharon.cole@phn-waco.org

Sign In or Register to comment.