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ICD9 help - uroseptic septic shock

  1. #1
    Default ICD9 help - uroseptic septic shock
    Exam Training Packages
    How would you code "uroseptic septic shock"
    Karen, CPC
    Physician Chart Auditor

  2. #2
    Default Uroseptic Shock
    Hi-

    If you refer to the ICD9 guidelines:

    Section I. Conventions, general coding guidelines and chapter specific guidelines.

    C. Chapter-Specific guidelines

    1. Chapter 1L Infectious diseases

    b. Septicemia, SIRS, sepsis, septic shock,

    6a. Septic Shock....

    Follow this trail and it should lead you down the right path.

    Hope this helps.

    Carmen
    SIZE="4"] ~Carmen C. Brooks, CPC-I, CPC-H, CCS~[/SIZE][/SIZE]

  3. #3
    Default Uro is non-specific
    Use default coding for this and read your guidelines Section 1, C, 3 under Note:
    Don't forget to add for causl organism

    This seems like a test question...I think i have seen thid posted somewher on this site before

    Good Luck
    KellyLR
    KL
    CCS, RHIT, CPC, CMBS

  4. #4
    Default
    Thanks Guys.

    No it is not a test question -- its an actual diagnosis from a chart I'm working on. It was originally coded 599.0, but its documented a few times as "uroseptic septic shock".
    Karen, CPC
    Physician Chart Auditor

  5. #5
    Default
    I'd go with 995.91 and follow guidelines.

    Tonyj

  6. #6
    Location
    Columbia, MO
    Posts
    12,560
    Default
    995.91 is not allowed first listed. The guidelines for septic shock:
    Septic shock
    (a)
    Sequencing of septic shock
    Septic shock generally refers to circulatory failure associated with severe sepsis, and, therefore, it represents a type of acute organ dysfunction.
    For all cases of septic shock, the code for the systemic infection should be sequenced first, followed by codes 995.92 and 785.52. Any additional codes for other acute organ dysfunctions should also be assigned. As noted in the sequencing instructions in the Tabular List, the code for septic shock cannot be assigned as a principal diagnosis.
    (b)
    Septic Shock without documentation of severe sepsis
    Septic shock indicates the presence of severe sepsis.
    Code 995.92, Severe sepsis, must be assigned with code 785.52, Septic shock, even if the term severe sepsis is not documented in the record. The “use additional code” note and the “code first” note in the tabular support this guideline.
    Also the guidelines state if the systemic infection is not documented then you code 038.9 first listed.

    Debra A. Mitchell, MSPH, CPC-H

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