GI Bleed and I-10

katysuegood@gmail.comkatysuegood@gmail.com
in CDI Talk Archive
In I-10 what do we do with hemorrhagic shock 2/2 to GI bleed? The only codes for Hemorrhagic shock route to traumatic or postprocedural shock. Do we no longer get shock in these cases or should it be documented/routed to hypovolemic or other shock?

I feel like I learned this at one point but don't remember it now :(

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

  • lsipos@monument.healthlsipos@monument.health
    edited April 2016
    Katy

    We just had this discussion last week! I am hoping your email can shed some light!

    Juli
    Juli Bovard RN CCDS
    Certified Clinical Documentation Specialist
    Clinical Effectiveness/Clinical Quality
    Rapid City Regional Hospital
    755-8426 (work)
    786-2677 (cell)
  • kerryseekircherkerryseekircher
    edited April 2016
    Good question. I'm trying to group this now and see what you are saying.
    As it's not postop or trauma related, I would likely select shock-other specified, which brings you to R578.
    I looked for a clinic and couldn't find any, so I'm curious to hear others opinions on this.
    Thanks,
    Kerry

    Kerry Seekircher, RN, BS, CCDS, CDIP
    Clinical Documentation Program Manager
    Northern Westchester Hospital
    400 East Main Street
    Mount Kisco, NY 10549
    Email: kseekircher@nwhc.net
    Phone: 914-666-1243
    Fax: 914-666-1013
  • jrileyjriley
    edited April 2016
    Back in I-9 world we also had no specific code for hemorrhagic shock, however most groupers offered that description as an option and then took you to the all-purpose code 785.59 "shock without trauma." In I-10 we have the more specific option of coding hypovolemic shock, R57.1 if it is documented, or simply "other shock" R57.8, when associated with hemorrhage. R57.8 would be my choice if the hypovolemia were not documented, but I would query for that documentation to get to the more specific R57.1.

    Judy Riley, RHIT, CCS, AHIMA-Approved ICD-10 Trainer
    CDI/Coding Manager
    LRGHealthcare
    jriley@lrgh.org

  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited April 2016
    I, too, would code hemorrhagic shock to R57.8 - rationale: This is the code for "Other" forms of shock and the other codes available describe specific types of shock. R57.8 is an MCC. Notable that 1-10 does not call for specificity for Hemorrhagic Shock as this must represent a common cause of morbidity in the population, and I'd think CDC would like to be able to track hemorrhagic shock as a separate item.



    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: 415.412.9421

  • lsipos@monument.healthlsipos@monument.health
    edited April 2016
    Katy



  • katysuegood@gmail.comkatysuegood@gmail.com
    edited April 2016
    Yes, I believe we came to the conclusion that 'other shock' should be coded in this scenario though you could query for further specificity of hypovolemic shock.

    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

Sign In or Register to comment.