b Sepsis due to a postprocedural infection For such cases the postprocedural

B sepsis due to a postprocedural infection for such

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(b) Sepsis due to a postprocedural infection For such cases, the postprocedural infection code, such as T80.2, Infections following infusion, transfusion, and therapeutic injection, T81.4, Infection following a procedure, T88.0, Infection following immunization, or O86.0, Infection of obstetric surgical wound, should E. coli UTI N39.0 Urinary tract infection, site not specified B96.20 Unspecified Escherichia coli [E.coli] as the cause of diseases classified elsewhere Explanation: An instructional note under the code for the urinary tract infection indicates to code also the specific organism. Gram-negative sepsis A41.50 Gram-negative sepsis, unspecified Staphylococcal sepsis A41.2 Sepsis due to unspecified staphylococcus Explanation: In both examples above the organism causing the sepsis is identified, therefore A41.9 Sepsis, unspecified organism, would not be appropriate as this code would not capture the highest degree of specificity found in the documentation. Do not use the additional code for severe sepsis unless documented as severe sepsis with acute organ dysfunction. Sepsis and acute respiratory failure due to COPD exacerbation A41.9 Sepsis, unspecified organism J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation J96.00 Acute respiratory failure, unspecified whether with hypoxia or hypercapnia Explanation: Although acute organ dysfunction is present in the form of acute respiratory failure, severe sepsis (R65.2) is not coded in this example, as the acute respiratory failure is attributed to the COPD exacerbation rather than the sepsis. Sequencing of these codes would be determined by the circumstances of the admission. Sepsis with septic shock A41.9 Sepsis, unspecified organism R65.21 Severe sepsis with septic shock Explanation : Documentation of septic shock automatically implies severe sepsis as it is a form of acute organ dysfunction. Septic shock is not coded as the principal diagnosis; it is always preceded by the code for the systemic infection. Patient presents with acute renal failure due to severe sepsis from Pseudomonas pneumonia A41.9 Sepsis, unspecified organism J15.1 Pneumonia due to Pseudomonas R65.20 Severe sepsis without septic shock N17.9 Acute kidney failure, unspecified Explanation: If all conditions are present on admission, the systemic infection (sepsis) is sequenced first followed by the codes for the localized infection (pneumonia), severe sepsis and any organ dysfunction. If only the pneumonia was present on admission with the sepsis and resulting renal failure developing later in the admission, then the pneumonia would be sequenced first.
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Chapter 1. Certain Infectious and Parasitic Diseases ICD-10-CM 2017 Chapter 1. Certain Infectious and Parasitic Diseases Guidelines and Examples ICD-10-CM 2017 431 be coded first, followed by the code for the specific infection. If the patient has severe sepsis, the appropriate code from subcategory R65.2 should also be assigned with the additional code(s) for any acute organ dysfunction.
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