Wiki Chronic respiratory failure

tbalasrinivas22

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Chronic respiratory failure with hypoxia 2/2 to pulmonary hypertension, reason for admission SOB, treated with increased supplemental oxygen what would be PDX.
 
I personally suggest a query. I don't have the chart in front of me and can only go off what you have included but it sounds like there is a decompensation of the respiratory failure going on here if there is a need for increased oxygen.
 
According to the UHDDS, the principal diagnosis is defined as "that condition established after study to be chiefly responsible for occasioning the admission of the patient to the hospital for care". Since the respiratory failure is happening as a result of the pulmonary hypertension, I would code pulmonary hypertension, I27.0 as the pdx.
 
Looks like they're treating both with supplemental O2

Agree with above, but also according to UHDDS, selection of principal diagnosis (-es) is arbitrary if both are being treated with same level of care.

Since chronic respiratory failure is kind of a vague way of saying this person has chronically low saturation levels, due to some other lung/respiratory disease; BUT PHTN, combined with O2, is also usually treated with lasix/diuretics and/or vasodilators, I would look for the use of those If I was going to code PHTN first... just my two cents based on the info you gave. but I think you'd withstand audit with either one.
 
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