Pulmonology Coding Alert

Question: What is respiratory acidosis, and what ICD-9 codes should I use to represent the condition?


Minnesota Subscriber
 

Answer: Respiratory acidosis occurs when excess carbon dioxide builds up in a patient's blood stream. This results in the patient's blood pH decreasing. Acute airway obstruction, acute lung infections or inflammation, bronchial tissue infections, and other acute or chronic lung conditions can result in the elevation of carbon dioxide in the arterial blood. 

There are three types of respiratory acidosis:

• Acute respiratory acidosis is the result of a sudden respiratory system compromise, due to many causes (some of those causes are acute airway obstruction, lung infections, inflammations, etc.).

• Chronic respiratory acidosis occurs when there is a prolonged loss of ventilatory function.

• Acute and chronic respiratory acidosis is similar to acute acidosis but occurs in a patient with chronic respiratory acidosis. However, early signs of respiratory distress apparent in patients with acute respiratory acidosis may be missing in patients with acute and chronic respiratory acidosis.

You should report acute respiratory acidosis with the diagnosis code 518.81 (Acute respiratory failure).

According to ICD-9, this code excludes:

• acute and chronic respiratory failure (518.84)

• acute respiratory distress (518.82)

• chronic respiratory failure (518.83)

• respiratory arrest (799.1)

• respiratory failure, newborn (770.84)