hospital criteria for acute respiratory failure

My facility is trying to come up with a clear definition of acute respiratory failure. we all know that as far as denials go, respiratory failure is what the insurance companies say it is. Where we can make a difference is to get the providers be on the same page as far as the definition of acute respiratory health failure. By doing this, at least the documentation in the medical record will be more consistent and clinical support will be there for this diagnosis.

I would like to know what other facilities use as far as criteria for acute respiratory failure and what clinical support do you look for.

Thank you


  • We use respiratory distress plus oxygen need of 2 L or greater. Basically, it is similar to what the insurance companies were saying. Our CDI department will calculate the pO2/FIO2 if needed but was not needed prior. However, now we are getting more denials saying that we cannot use calculations using the oxygen saturation or a VBG. While I agree with not using the VBG, requiring an ABG or room air saturations that are low with someone on high flow oxygen is ridiculous. Anyone else having similar issues?

    • Janel
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