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Wiki Respiratory Failure

brodel

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Is it ok to assume a diagnosis of respiratory failure when all the Dr. documents are the vent settings under his assessment and plan yet he does NOT document "respiratory failure"??

I don't feel this is an "ok" practice but I'm getting some mixed opinions. Any help would be appreciated.
 
I would definately not code the respiratory failure if the provider did not state it him or herself. We as coders cannot infer this information.
 
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