Not Quite Respiratory Failure

jkrespach@ehr.org

Suggestions please:  Our providers are asking if there is a suggested diagnosis or term in the situation where a patient may not meet Acute Respiratory Failure criteria, yet are requiring some extra O2, monitoring, maybe delayed DC because of weaning O2 (as examples) in the non-surgical patient.  Is Acute Respiratory Distress a valid option?  What dx options may help the provider capture the acuity of this scenario?

BTC2018

Assign a code for the underlying reason for the need of extra O2 that is causing the pulmonary insufficiency or respiratory insufficiency; can also code Z99.81, dependency on supplemental O2. I would not code acute respiratory distress unless it is clinically present and the reason for the O2. Underlying conditions (COPD, CHF, etc.) may become decompensated or exacerbated during admission or post surgery and are often the reason, so it will be a case by case basis. 

evanspx@sutterhealth.org

Would also mention the terms ‘respiratory distress’ and ‘respiratory distress syndrome’ have different codes and impact.

BTC2018

https://forums.acdis.org/discussion/3915/acute-pulmonary-insufficiency#latest