AIDS and Sepsis

I am reviewing a chart where the patient has AIDS and Sepsis both POA. The sepsis is either from the patient's PCP pneumonia or his CMV colitis (still determining this). Since these are primarily AIDS related illnesses, I was not sure if the AIDS would be the principal or does the sepsis become the principal?

Comments

  • I think the AIDS would be the PDx. If you sequence sepsis first, it remains in the AIDS DRG. Also, seems correct as PDx given that the sepsis is likely due to the AIDS related illness (and the patient may not have even become septic if did not have AIDS).

    Sequencing of HIV and HIV-related conditions 10/1/1994

    ICD-9-CM Coding Clinic, Fourth Quarter 1994 Page: 30 to 31 Effective with discharges: October 1, 1994

    10.4 Sequencing

    The sequencing of diagnoses for patients with HIV-related illnesses follows guideline 2 for selection of principal diagnosis. That is, the circumstances of admission govern the selection of principal diagnosis, "that condition established after study to be chiefly responsible for occasioning the admission of the patient to the hospital for care."

    Patients who are admitted for an HIV-related illness should be assigned a minimum of two codes: first assign code 042 to identify the HIV disease and then sequence additional codes to identify the other diagnoses. If a patient is admitted for an HIV-related condition, the principal diagnosis should be 042, followed by additional diagnosis codes for all reported HIV-related conditions.

    If a patient with HIV disease is admitted for an unrelated condition (such as a traumatic injury), the code for the unrelated condition (e.g., the nature of injury code) should be the principal diagnosis. Other diagnoses would be code 042 followed by additional diagnosis codes for all reported HIV-related conditions.

  • Thank you Amy! Appreciate the reference as well.

    -Cheree

  • Hi, I had a case recently and I queried was Sepsis related to or unrelated to HIV ( not listed as AIDS), and the documentation only stated HIV well controlled on meds. I took that as unrelated... did I view it correctly? 
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