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Icd-9cm sirus and sepis

  1. #1
    Default Icd-9cm sirus and sepis
    Medical Coding Books
    Is my selection correct for this scenario?

    481,995.90 1st DX.

    038.9,995.91,584.9 2dn DX.

    My confusion lies in whether you can code, SIRS and Sepis together when there stated on different areas of the note.

    1) RLL PNA: severe multilobar pneumonia with SIRS.
    broad spectrum abx: agree w vanco/levaquin. add cefepime
    -cont fluid resuscitation
    -sputum gram stain and cultures, f/u blood culture result
    -supportive care
    -bronchodilators and resp toilet

    2)Acute renal failure: pre-renal versus ATN from sepsis
    fluid and supportive care


  2. #2
    Columbia, MO
    From the coding guidelines:
    Sepsis generally refers to SIRS due to infection.
    Severe sepsis generally refers to sepsis with associated acute organ dysfunction.

    Sepsis/SIRS with Localized Infection
    If the reason for admission is both sepsis, severe sepsis, or SIRS and a localized infection, such as pneumonia or cellulitis, a code for the systemic infection (038.xx, 112.5, etc) should be assigned first, then code 995.91 or 995.92, followed by the code for the localized infection. If the patient is admitted with a localized infection, such as pneumonia, and sepsis/SIRS doesn’t develop until after admission, see guideline I.C.1.b.2.b)

    This just an excerpt from the guidelines they cover this topic very well so I would encourage you to read this section.
    but you cannot have an organ dsyfunction and no organ dysfunction together so you need to defer your sepsis code to the 995.91 for the organ dysfunction.

    Debra A. Mitchell, MSPH, CPC-H

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