sepsis with spider bite

katysuegood@gmail.comkatysuegood@gmail.com
in CDI Talk Archive
We have a patient that was bit by a venomous spider and came in with sepsis. Patient also required an excisional debridement. Since the spider bite will code to a toxic effect code (989.5), which should be sequenced first per coding guidelines, does the sepsis or the toxic effect become the principle diagnosis?

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

  • ssalinasssalinas
    edited April 2016
    Is this a case where the physician really means SIRS due to noninfectious process or was there an infectious process going on? If it is sepsis, then the underlying infection needs to be principal dx - I think. If there is no underlying infection and it is SIRS, then the toxic effect would be principal.

    Just my thoughts..

    Sharon Salinas, CCS
    Health Information Management
    Barlow Respiratory Hospital
    2000 Stadium Way, Los Angeles CA 90026
    Tel: 213-250-4200 ext 3336
    FAX: 213-202-6490
    ssalinas@barlow2000.org
  • katysuegood@gmail.comkatysuegood@gmail.com
    edited April 2016
    There was an infection associated with the bite, positive cultures.

    Thanks Sharon!

    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

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