Chronic Respiratory Failure

Patient admitted to hospital with no history of home oxygen. Has O2 throughout visit and Home O2 Eval completed. Qualifies for home O2 and will be sent home on O2 2L NC cont.

Do you query for Chronic Respiratory Failure? There has been some conversations regarding if this can be counted as Chronic Respiratory Failure even though the patient did not have Home O2 when they were admitted.

Comments

  • A problem does not have to be present on admission to be coded as a secondary diagnosis.  Chances are the patient had some indications or risk factors for chronic respiratory failure when she came in (COPD, pulm fibrosis, CHF?)  and this admission may have tipped her over the edge.  The condition was assessed and treated and treatment plan made for post-hospitalization, this meets criteria for coding the secondary diagnosis of Chronic Respiratory Failure if she will be dependent on oxygen 24/7. 
  • We would query based on :

    Does the patient have a chronic lung disease and meet any of the following criteria?

    • Continuous home 02 of ≥2 liters

    • ABG:  pH >7.35 and PCO2 > 50 mmHg

    • Chronic home mechanical ventilation

    • Elevated bicarbonate level of >35 from basic metabolic panel (BMP) lab

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