Post op respiratory failure

jmeegan

Wondering how other CDI/Coding departments code out these cases and rationale.  Example--surgical patient requiring Bi-Pap overnight following surgery, weaned to RA over next 2 days. Documentation states "Acute respiratory failure with hypoxia--multifactorial--anesthesia, COPD, patient is long time smoker". 

Acute respiratory failure with hypoxia--J96.01 or  Post op respiratory failure J95.821

Key word here being anesthesia, included as a factor.  Our coding department considers any respiratory failure in the post op period, where anesthesia is documented as a factor (even in the presence of underlying conditions), to be "post op respiratory failure".  I am curious if this is how others are coding these out, because it affects our PSI 11 rates.

vparent@emhs.org

We evaluate any account that has ANY type of respiratory failure post op. If the patient has known underlying chronic lung conditions we ask the physician to consider if that is the cause vs "surgery". We also do not usually include the first 24 hours after surgery if the patient stays vented. If a patient is extubated and requires reintubation, it is definitely respiratory failure.