sepsis and organisms

Hi,

Need some help. CC 4th Qtr 1988 page 10 instructs to assign the specific septicemia code of the specified organism & the code for the local infection. Would it be appropriate to assign the specific septicemia code of the specified organism when blood cultures are negative and the body fluid culture is positive, and the physician describes his diagnosis as "Sepsis secondary to (localized infection)(with the specified organism)"?

For example: Septic Shock due to c-diff colitis; sepsis due to streptococcal pneumonia; or sepsis due e-coli uti

Your responses would be greatly appreciated.


Helga Reina, RHIT, CDIP, CCA, C-CDI
Documentation Improvement Specialist
Hunterdon Medical Center

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Comments

  • Helga: I code as per your scenario - that is - if/when the clinician links an organism to the sepsis, I code to the specific type of sepsis
    Paul

    Paul Evans, RHIA, CCS, CCS-P, CCDS

    Manager, Regional Clinical Documentation & Coding Integrity
    Sutter West Bay
    633 Folsom St., 7th Floor, Office 7-044
    San Francisco, CA 94107
    Cell: 415.637.9002
    Fax: 415.600.1325
    Ofc: 415.600.3739
    evanspx@sutterhealth.org

  • edited May 2016
    I agree with Paul.



    Mary A Hosler MSN, RN
    Clinical Documentation Specialist
    Alumnus CCRN
    McLaren Bay Region
    1900 Columbus Ave.
    Bay City, Michigan 48708
    (989) 891-8072
    mary.hosler@mclaren.org

    "The difference between the right word and the almost right word is the difference between lightning and the lightning bug."- Samuel "Mark Twain" Clemens

  • edited May 2016

    Hi Paul and Mary,

    Thanks for your response. That is the route I would take as well
    because the clinician has made the link .

    So for instance : "Sepsis due to e-coli UTI". Clinically the patient
    has sepsis, urine cultures positive for e-coli, blood cx's neg , you
    would use the following codes

    03842 septicemia due to E coli
    99591 sepsis
    5990 UTI, site not specified

    and NOT use the unspecified septicemia code 0389.


    Helga Reina, RHIT, CDIP, CCA, C-CDI
    Documentation Improvement Specialist
    Hunterdon Medical Center


  • Precisely, the link has been documented, so use the more specific codes you cited.
    I use 038.9 too often, but prefer to use more precise codes, when possible.
    Paul
    Paul Evans, RHIA, CCS, CCS-P, CCDS

    Manager, Regional Clinical Documentation & Coding Integrity
    Sutter West Bay
    633 Folsom St., 7th Floor, Office 7-044
    San Francisco, CA 94107
    Cell: 415.637.9002
    Fax: 415.600.1325
    Ofc: 415.600.3739
    evanspx@sutterhealth.org

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