Sepsis and COVID

CDI and coders are having a discussion regarding  what should be coded as Principle diagnosis.  I feel that the patient has been tested, screened  and treated for COVID and even placed in a special unit  for COVID + patients. Our resources  are being used up to treat the COVID so I feel that this should be the principle but the coders don't agree with this.   Any thought would be appreciated. Thanks Allison

Comments

  • Hi Allison

    Was the sepsis present on admission? Was the sepsis due to COVID-19 pneumonia (the localized infectious source)? If so, the sepsis code is sequenced first. This issue is discussed on p. 8 of 2nd Q 2020 Coding Clinic.

  • Thanks for the information and yes they were all present on admission

  • Thank you Margaret! I am having the opposite problem with our coders here.. Several cases : COVID, Sepsis, Viral pneumonia are all present on admission. Documentation stated Sepsis from COVID, PNA. Coders want to sequence COVID as principal since there is no 'due to' or 'with' association.  CDI did not initially query because 1) 'from' is essentially the same clinically as 'due to. and we figured we can apply the sepsis guideline of sepsis + local infection sequencing. Coding states many of the treatments were associated with respiratory failure.. and this is their reasoning for sequencing COVID as PDX instead of sepsis? What i

  • Question regarding drains.  Had a patient that came in with post op infection/seroma and was taken to the OR with I&D with two hemovacs placed. Was coded with drainage device (Hemovac) . After an audit of charts we were told we could not could a hemovac/ penrose drain because that was part of the surgery to help drain the surgical wound.  Would love feed back on this. Thanks, Allison

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