Pediatric Respiratory Distress/Failure - Continued from prior post
Acute Pediatric Respiratory Distress/ Respiratory Failure
Many of us in Pediatric CDI have been frustrated as to the lack of specificity of diagnoses and lack of attention that CMS/payers have given to pediatrics in regards to certain diagnoses and our ability to accurately portray the level of severity of illness that certain children exhibit, as to be fairly compensated for the time, expertise and resources that are involved with their care. There is a great deal of difference between the patient with bronchiolitis that stays in the hospital for a day with minimal care and the patient with bronchiolitis that has increased work of breathing and needs increased level of care and several days in the hospital. Or the asthmatic patient who need a few Albuterol nebs and steroids before they go home and the asthmatic that requires IV steroids and multiple treatments with increased frequency that stay for a few days. In both these scenarios - the diseases are the same but they are definitely not the same patients – the intensity of care and length of stay can be vastly different.
I understand that respiratory distress will code to ARDS in ICD-10 – and after conversation with Dr. Robert Gold of DCBA and the “guru†of CDI, we discussed this not being an appropriate diagnosis for patients as described above. These are examples of how pediatrics is not being well attended to in the world of classification of diseases.
There needs to be a push in pediatrics to establish criteria that will accurately reflect the severity of disease that is not captured utilizing adult criteria. Dr. Gold was very helpful and will help with an initiative to help address this lack of specificity for respiratory distress. Dr. Gold stated that participation from individual physicians at a number of institutions would be required to help push this forward. Perhaps we can discuss this in San Antonio as well as through this blog. As always we appreciate Dr. Gold’s time, wisdom and energy in helping address this issue. I hope to get everyones input regarding this topic
Doug Campbell
Many of us in Pediatric CDI have been frustrated as to the lack of specificity of diagnoses and lack of attention that CMS/payers have given to pediatrics in regards to certain diagnoses and our ability to accurately portray the level of severity of illness that certain children exhibit, as to be fairly compensated for the time, expertise and resources that are involved with their care. There is a great deal of difference between the patient with bronchiolitis that stays in the hospital for a day with minimal care and the patient with bronchiolitis that has increased work of breathing and needs increased level of care and several days in the hospital. Or the asthmatic patient who need a few Albuterol nebs and steroids before they go home and the asthmatic that requires IV steroids and multiple treatments with increased frequency that stay for a few days. In both these scenarios - the diseases are the same but they are definitely not the same patients – the intensity of care and length of stay can be vastly different.
I understand that respiratory distress will code to ARDS in ICD-10 – and after conversation with Dr. Robert Gold of DCBA and the “guru†of CDI, we discussed this not being an appropriate diagnosis for patients as described above. These are examples of how pediatrics is not being well attended to in the world of classification of diseases.
There needs to be a push in pediatrics to establish criteria that will accurately reflect the severity of disease that is not captured utilizing adult criteria. Dr. Gold was very helpful and will help with an initiative to help address this lack of specificity for respiratory distress. Dr. Gold stated that participation from individual physicians at a number of institutions would be required to help push this forward. Perhaps we can discuss this in San Antonio as well as through this blog. As always we appreciate Dr. Gold’s time, wisdom and energy in helping address this issue. I hope to get everyones input regarding this topic
Doug Campbell