Respiratory failure, unspecified, unspecified whether with hypoxia or hypercapnia
Signs and symptoms of respiratory failure may include shortness of breath, rapid breathing, and air hunger (feeling like you can't breathe in enough air). In severe cases, signs and symptoms may include a bluish color on your skin, lips, and fingernails; confusion; and sleepiness .
ICD-10 code J96. 01 for Acute respiratory failure with hypoxia is a medical classification as listed by WHO under the range - Diseases of the respiratory system .
ICD-10 code Y84. 4 for Aspiration of fluid as the cause of abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure is a medical classification as listed by WHO under the range - Complications of medical and surgical care .
Secondary diagnosis: Respiratory failure may be listed as a secondary diagnosis if it occurs after admission, or if it is present on admission, but does not meet the definition of principal diagnosis.
Hypoxemic respiratory failure means that you don't have enough oxygen in your blood, but your levels of carbon dioxide are close to normal. Hypercapnic respiratory failure means that there's too much carbon dioxide in your blood, and near normal or not enough oxygen in your blood.
ICD-10 code J69. 0 for Pneumonitis due to inhalation of food and vomit is a medical classification as listed by WHO under the range - Diseases of the respiratory system .
J69. 0 - Pneumonitis due to inhalation of food and vomit. ICD-10-CM.
Respiratory failure, unspecified, unspecified whether with hypoxia or hypercapnia. J96. 90 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
Currently, the direction states that either the acute respiratory failure or the established etiology can be sequenced first; however, we must take the circumstances of the encounter into account. Many cite the coding convention related to etiology/manifestation as dictating that the etiology must be sequenced first.
Can you clarify this? A: We recommend a query for respiratory failure in these circumstances if not documented. O2 saturation (SpO2) < 91% on room air or P/F ratio < 300 on oxygen is a clear indicator of acute respiratory failure in patients who do not require continuous home O2.
The acute hypoxemic RF arising from widespread diffuse injury to the alveolar-capillary membrane is termed Acute Respiratory Distress Syndrome (ARDS), which is the clinical and radiographic manifestation of acute pulmonary inflammatory states.
Lung damage in the course of this disease often leads to acute hypoxic respiratory failure and may eventually lead to acute respiratory distress syndrome (ARDS). Respiratory failure as a result of COVID-19 can develop very quickly and a small percent of those infected will die because of it.
Acute respiratory distress syndrome (ARDS) is a form of acute-onset hypoxemic respiratory failure caused by acute inflammatory edema of the lungs and not primarily due to left heart failure.
The respiratory failure, however, is not one of these pairs, so there is no direction for the underlying cause being sequenced first. So, with no guidelines saying otherwise, the respiratory failure could be sequenced as the principal diagnosis.
So, acute respiratory failure can be coded if the condition meets the definition for the principal diagnosis and is clinically supported in the medical record by a hands-on treating provider without any conflict existing in the documentation between any consulting and attending provider.
Look for documented signs / symptoms of: SOB (shortness of breath) Delirium and/or anxiety. Syncope. Use of accessory muscles / poor air movement.
Very seldom is it a simple cut and dry diagnosis. There always seems to be just enough gray to give coders on any given day some doubt. It’s not only important for a coder to be familiar with the guidelines associated with respiratory failure but they should also be aware of the basic clinical indicators as well.
A patient with a chronic lung disease such as COPD may have an abnormal ABG level that could actually be considered that particular patient’s baseline.
Acute or Acute on Chronic Respiratory Failure may be assigned as a principal diagnosis when it is the condition established after study to be chiefly responsible for occasioning the admission to the hospital, and the selection is supported by the Alphabetic Index and Tabular List. However, chapter-specific coding guidelines (such as obstetrics, poisoning, HIV, newborn) that provide sequencing direction take precedence.