post-procedural resp failure

katysuegood@gmail.comkatysuegood@gmail.com
in CDI Talk Archive
We have a patient that had a nerve stim placed and then after the surgery developed an asthma exacerbation with acute resp failure requiring prolonged LOS. The coder is coding this to J85.821 however I am not sure we should be specifying this as post-procedural? The resp failure is stated as 'acute hypoxic respiratory failure secondary to Astha/COPD exacerbation'. I guess I am second guessing this as I-10 is new. In I-9 I would not have recommended codign post op respiratory failure in this case as the ARF is due to an underlying chronic condition as opposed to the surgery. Did anything change in ICD-10?

Thoughts?

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

  • katysuegood@gmail.comkatysuegood@gmail.com
    edited April 2016
    I should add, this was an outpatient encounter moved to IP 3 days later due to the resp issues...

    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

  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited April 2016
    I agree w/ your logic....coder should code this as 2/2 pulmonary disease you cited and use of the code for P.O. may imply a quality issue..the asthma/COPD caused the failure, not the procedure. There have been numerous discussion about this topic in our Journal, and I recall Dr. Gold provides much insight into this scenario.



    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

    evanspx@sutterhealth.org

    [cid:image001.jpg@01D105A1.503EC6E0]

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