Wiki Sue Allison, CPC

SAAllison

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When a patient has had a major surgical procedure (i.e. CABG) and they are admitted to the SICU and have not been extubated yet, do we use code 518.51(acute respiratory failure following trauma and surgery) or 518.81(acute respiratory failure) for the management by the SICU physicians?
 
I would use 518.51 if the resp failure started after the trauma or surgery or is dur to the surgery. I would use 518.81 if the rep failure was dx before the surgery and not due to the surgery.
 
Intubation is a normal part of a CABG, you would not code respiratory arrest for this at all unless the patient had been intubated due to resp arrest prior to the surgery. For vent management that is a normal part of the surgery use a V code for either fitting and adjustment or surgical aftercare.
 
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