I summarized this a while back from my days working in Critical Care. I think R57.8 is the correct choice.
Classifications of
Circulatory Shock
A.
Hypodynamic shock- low cardiac index and a high-resistance vasoconstricted state. Increased
oxygen extraction and lactic acidosis usually parallel the decrease in cardiac
output. The development of organ dysfunction is directly related to inadequate
global blood flow.
Types:
1. Hypovolemic Shock
(do to dehydration and massive capillary leak) R57.1
2. Hemorrhagic Shock 2/2
surgery T81.19 2/2 trauma T79.4
3. Cardiogenic Shock-(MI,
Cardiomyopathies, and severe valvular lesions) R57.0
B.
Hyperdynamic shock - high cardiac output and a low-resistance
vasodilated state.
Types:
5. Vasodilatory Shock
(Filling pressures can be increased or normal depending on volume status and myocardial
competence) R 57.8
6. Septic Shock R65.21
7. Anaphylactic Shock
T78.2
8. Spinal Shock R57.8
9. Vasoplegic orDistributive shock (Adrenal
insufficiency where the underlying hemodynamic defect is maldistribution of
blood flow and/or blood volume such that effective nutrient blood flow is
compromised.) R 57.8
Considerable overlap may exist between these different
syndromes. Early in septic and anaphylactic shock, prior to fluid infusion, a
significant hypovolemic component usually exists. Hypovolemia may be present in
a small group of patients presenting with shock due to acute myocardial
infarction. In the presence of severe sepsis-related myocardial depression,
patients with septic shock can develop a hypodynamic profile. Similarly,
patients in cardiogenic shock after myocardial infarction and cardiac surgery
may demonstrate significant vasodilation due to the activation of mediator
cascades while on cardiopulmonary bypass.
Comments
I guess technically it's "other" but just curious if there were indicators for a more specific code?
Jeff
Classifications of Circulatory Shock
A. Hypodynamic shock - low cardiac index and a high-resistance vasoconstricted state. Increased oxygen extraction and lactic acidosis usually parallel the decrease in cardiac output. The development of organ dysfunction is directly related to inadequate global blood flow.
Types:
1. Hypovolemic Shock (do to dehydration and massive capillary leak) R57.1
2. Hemorrhagic Shock 2/2 surgery T81.19 2/2 trauma T79.4
3. Cardiogenic Shock-(MI, Cardiomyopathies, and severe valvular lesions) R57.0
4. Obstructive Shock (pericardial tamponade, acute PE, and tension pneumothorax) R57.8
B. Hyperdynamic shock - high cardiac output and a low-resistance vasodilated state.
Types:
5. Vasodilatory Shock (Filling pressures can be increased or normal depending on volume status and myocardial competence) R 57.8
6. Septic Shock R65.21
7. Anaphylactic Shock T78.2
8. Spinal Shock R57.8
9. Vasoplegic or Distributive shock (Adrenal insufficiency where the underlying hemodynamic defect is maldistribution of blood flow and/or blood volume such that effective nutrient blood flow is compromised.) R 57.8
Considerable overlap may exist between these different syndromes. Early in septic and anaphylactic shock, prior to fluid infusion, a significant hypovolemic component usually exists. Hypovolemia may be present in a small group of patients presenting with shock due to acute myocardial infarction. In the presence of severe sepsis-related myocardial depression, patients with septic shock can develop a hypodynamic profile. Similarly, patients in cardiogenic shock after myocardial infarction and cardiac surgery may demonstrate significant vasodilation due to the activation of mediator cascades while on cardiopulmonary bypass.
Reference:
JEAN-LOUIS VINCENT, MD, PhD,
EDWARD ABRAHAM, MD
FREDERICK A. MOORE, MD, FACS, FCCM
PATRICK M. KOCHANEK, MD, FCCM
MITCHELL P. FINK, MD
2012 TEXTBOOK OF CRITICAL CARE