Influenza
What is the appropriate code for 'Influenza A' not further specified as to type by the physician?
Thanks!
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
Thanks!
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
Comments
Q: How should we code a diagnosis of influenza type A? Should we report ICD-9-CM code 487.1?
A: The correct ICD-9-CM code for a patient who has influenza with respiratory manifestations is 487.1.
Renee
Linda Renee Brown, RN, MA, CCDS, CCS, CDIP
Director, Clinical Documentation, Core Measures and Outcomes
Tanner Health System
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
HCPro, Inc., 75 Sylvan Street, Danvers MA 01923
Our coding manager forwarded this coding clinic and we are using this as a guideline. IF it is truly "Avian flu" the physician must document it.
Thanks
Lisa
Novel influenza A
Coding Clinic, Fourth Quarter 2011 Pages: 110-114 Effective with discharges: October 1, 2011
Effective October 1, 2011, codes in subcategory 488.1, Influenza due to identified novel H1N1 influenza virus, have been retitled to state "Influenza due to identified 2009 H1N1 influenza virus." The 2009 pandemic influenza is now regularly referred to as 2009 H1N1 influenza, rather than novel H1N1 influenza. Additionally, a new subcategory and new codes have been created to describe novel influenza A. The new codes include Influenza due to identified novel influenza A virus with pneumonia (488.81); Influenza due to identified novel influenza A virus with other respiratory manifestations (488.82); and influenza due to identified novel influenza A virus with other manifestations (488.89). These revisions were recommended by the Centers for Disease Control (CDC) and the National Center for Immunization and Respiratory Diseases (NCIRD).
There are two major kinds of influenza viruses, types A and B. These human influenza viruses spread in people and are the cause of seasonal flu epidemics each year. In the spring of 2009, a new strain of influenza A H1N1 virus emerged, causing the first influenza pandemic in more than 40 years.
Influenza A viruses can be broken down into subtypes that are based on two proteins on the surface of the virus: the hemagglutinin (H) and the neuraminidase (N). There are 16 different hemagglutinin subtypes and 9 different neuraminidase subtypes. Influenza A viruses can be further broken down into different strains. Current subtypes of influenza A viruses found to be transmitted in people are influenza A H1N1and influenza A H3N2 viruses. Over the course of a flu season, subtypes of influenza A viruses can circulate and cause illness. In addition, influenza viruses are constantly changing through a process called "antigenic drift."
Influenza due to identified novel influenza A virus is a nationally reportable disease. It includes all human infections with influenza A viruses that are different from currently circulating human influenza viruses. These include viruses subtyped as nonhuman in origin, and those that are unsubtypable with standard laboratory methods.
Similar to the guidelines for coding HIV and avian influenza infection, codes 488.81 to 488.89 should be assigned only for confirmed cases of novel influenza A virus. Codes 488.81-488.89 are not assigned when the final diagnostic statement indicates that the infection is "suspected," "possible," "likely," or "questionable." This is an exception to the hospital inpatient guideline that directs the coder to assign a code for a diagnosis qualified at the time of discharge as suspected or possible as if it were established. Refer to the Official Guidelines for Coding and Reporting Section 1.C.8.d. for additional information.
Question:
The ICD-9-CM Alphabetical Index does not have an entry for H1N1 or swine flu. The Index does have an entry for novel A/H1N1 and novel (2009) H1N1. When a physician documents "swine flu" or "H1N1," is it appropriate to assign the code for novel (2009) H1N1, 488.1? Or should 487.1 be assigned?
Answer:
There are several different strains of H1N1 influenza viruses, including some that are responsible for the seasonal flu. If the physician documentation is not specific regarding "novel H1N1" or "novel A/ H1N1" or "2009 H1N1" influenza, or "novel influenza A," coders should not assign codes from subcategory 488.1, Influenza due to identified 2009 H1N1 influenza virus or 488.8, Influenza due to novel influenza A, without physician clarification. Instead, assign code 487.1, Influenza.
Otis media or simple pna, with flu with respiratory symptoms...anyone have any idea of how it would lead me to each of the paths? I'd like to make sure I am doing it right and if there is anything to investigate to makes sure there is nothing to query to get into the other category...? I was wondering if the influenza A vs unspecified might matter?
Thanks,
Ann Donnelly,Rn,BSN,CCDS
annnd2009@gmail.com
Probably everyone else is aware but if you put influenza with respiratory complications unspecified it does take you to otis media without an mcc, and if you put influenza A with resp symptoms it takes you to Simple PNA without CC/MCC. If I am off in anyway - please correct me. Thanks,
Ann
Ann