UTI with chronic foley at admission
Hello, we are having several back and forth conversations with coding, CDI, and infection control concerning UTIs, chronic foleys, and NHSN definitions and proper coding. The main scenario in question is when a patient presents to the ED with a chronic foley already in place for greater than 3 days from a non-inpatient location and is admitted with a UTI. We understand that this does not meet the NHSN definition of a CAUTI since it was not in place for greater than 2 days while inpatient, but should we still be coding the T-code for the catheter associated infection or just a UTI? If the provider does not document the association between the UTI and the foley, should we send a query or just code a UTI? How do other hospitals handle this specific situation? This can make a big difference with DRG sometimes. Thank you.
Rebekka Malcolm
UVHN-CVPH
Comments
Hello Rebekka,
Great question and one we struggle with often. What we have to keep in mind is that infection control reports based on their defined criteria. Diagnosis codes are based on resource use and defined under the UHDDS.
If the provider correlates the foley to the UTI with a correlating term such as "due to" then we would code it as a UTI due to foley and utilize the T code (T83.51XA + N39.0). If the provider does not correlate, then we would query. The reason we would query is to ensure we are coding accurately and to the highest specificity. In addition, if this is a reason for admission we want to ensure we are coding to the correct DRG.
Hope that helps.
Deanne Wilk