Transcript ICD 9 Chap 11

The Complete
Diagnosis Coding Book
by
Shelley C. Safian, MAOM/HSM, CCS-P, CPC-H, CHA
Chapter 11
Coding Infectious Diseases
McGraw Hill/Irwin
Copyright © 2009 by The McGraw-Hill Companies, Inc. All rights reserved
11 - 2
Learning Outcomes
· Apply the guidelines for coding
diagnoses with HIV.
· Correctly code testing and test results
for infectious diseases.
· Distinguish between septicemia
and SIRS.
11 - 3
Learning Outcomes
· Identify the differences between severe
sepsis and sepsis.
· Place the codes for severe sepsis in the
correct sequence.
· Determine the correct guidelines for
coding tuberculosis.
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Introduction
· Infectious diseases are spread by
physical contact, such as a handshake or
the exchange of bodily fluids; others can
be spread by the touch of a doorknob
that has been handled by someone else.
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HIV Infections
· Only code this or any other
condition when clearly specified
in the physician’s notes.
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HIV Infections
· Testing for HIV: As with other
preventive health care encounters or
when the patient comes with no signs
or symptoms, use a V code.
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HIV Infections
· Test Positive:
· When the patient is asymptomatic, use
V08 Asymptomatic human
immunodeficiency virus [HIV]
infection status.
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HIV Infections
· Test Positive:
· When the patient has symptoms or
manifestations, use 042 Human
immunodeficiency virus [HIV]
disease.
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HIV Infections
· Once a patient has been reported
with code 042, this patient
· Cannot be reported with V08 ever again,
even after the manifestations have been
resolved.
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HIV Infections
· Unrelated Conditions: When a
patient visits a physician for a
concern other than HIV positive
status, HIV is almost always reported
because it is a systemic disease.
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Blood Infections
· Bacteremia: An abnormal blood
culture
· Septicemia: Blood infection,
generalized
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Blood Infections
· Signs and symptoms include:
· Increased body temperature (fever)
· Change in heart rate
· Change in respiratory rate
· Increased white cell count
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Blood Infections
· Pathogen: An identified cause of
infection or disease; bacteria or virus
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Blood Infections
· Systemic Inflammatory Response
Syndrome (SIRS): Signs and symptoms to
an unknown pathogen
· Sepsis: Two or more signs and symptoms; a
reaction to a specified pathogen
· Severe Sepsis: Sepsis + acute organ
dysfunction
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Blood Infections
· Septicemia
· 038.x
· Sepsis (Septicemia + SIRS)
· 038.x + 995.9x
· Severe Sepsis
· 038.x + 995.9x + code for organ failure
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Blood Infections
· Septic Shock Codes:
· 038.x
· + 995.92 or 995.94
· + code for septic shock such as 785.52
· + code for organ dysfunction
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Blood Infections
· SIRS without Infection:
· Code the underlying condition
· + 995.9x
· + code for organ dysfunction, when
applicable
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Tuberculosis
· Tuberculosis does not ONLY affect an
individual’s lungs but can infect many
different anatomical sites.
· Correct code will identify the specific
anatomical site.
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Bacterial Infections
· Food poisoning is not really a poisoning but
an infection:
· Campylobacter
· Vibrio
· Shigella
· Listeria
· Salmonella
· Clostridium perfringens
· Escherichia coli (E. coli O157)
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Other Infections
· Viral hepatitis, type A
· Viral hepatitis, type B
· Meningitis (viral or bacterial)
· Tetanus (lockjaw)
· Influenza (flu)
· Sexually transmitted diseases (STDs)
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Other Infections
· Varicella (chicken pox)
· Rubeola (measles)
· Rubella (German measles)
· Mumps
· Parasitic infections
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Chapter Summary
· The contagious nature of infectious
diseases makes them very serious.
· The coding of these conditions and their
treatment has statistical significance, in
addition to the importance of
reimbursement.