2021 ICD-10-CM Diagnosis Code J96.02 Acute respiratory failure with hypercapnia 2016 2017 2018 2019 2020 2021 Billable/Specific Code J96.02 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
Short description: Chronic obstructive pulmonary disease w (acute) exacerbation. The 2019 edition of ICD-10-CM J44.1 became effective on October 1, 2018.
The physician documented acute hypoxic respiratory failure due to COPD exacerbation. I coded acute respiratory failure first, but the coding professional reviewing the record said that was incorrect.
Acute respiratory failure, unspecified whether with hypoxia or hypercapnia. Short description: Acute respiratory failure, unsp w hypoxia or hypercapnia The 2019 edition of ICD-10-CM J96.00 became effective on October 1, 2018. This is the American ICD-10-CM version of J96.00 - other international versions of ICD-10 J96.00 may differ.
J96. 12 - Chronic respiratory failure with hypercapnia. ICD-10-CM.
Type 2 Respiratory Failure (hypercapnic): occurs when alveolar ventilation is insufficient to excrete the carbon dioxide being produced. Inadequate ventilation is due to reduced ventilatory effort or inability to overcome increased resistance to ventilation.
J96.00 – Acute respiratory failure, unspecified whether with hypoxia or hypercapnia.J96.01 – Acute respiratory failure, with hypoxia.J96.02 – Acute respiratory failure, with hypercapnia.
ICD-10 Code for Chronic respiratory failure, unspecified whether with hypoxia or hypercapnia- J96. 10- Codify by AAPC.
The physiological basis of acute respiratory failure in COPD is now clear. Significant ventilation/perfusion mismatching with a relative increase in the physiological dead space leads to hypercapnia and hence acidosis.
Acute hypercapnic respiratory failure is usually caused by defects in the central nervous system, impairment of neuromuscular transmission, mechanical defect of the ribcage and fatigue of the respiratory muscles. The pathophysiological mechanisms responsible for chronic carbon dioxide retention are not yet clear.
There are specific guidelines regarding the assignment of “Acute respiratory failure” as principal diagnosis: A code from subcategory J96. 0, Acute respiratory failure, or subcategory J96.
J96. 01 - Acute respiratory failure with hypoxia | ICD-10-CM.
Hypercapnia and hypoxia can exist either independently or together and there is no single combination code to describe the two conditions together. I have reported this as J96. 01 & J96. 02 frequently without any edits or denials.
ICD-10 code: J44. 1 Chronic obstructive pulmonary disease with acute exacerbation, unspecified.
Hypercapnia is the increase in partial pressure of carbon dioxide (PaCO2) above 45 mmHg. Carbon dioxide is a metabolic product of the many cellular processes within the body, and there are several physiological mechanisms that the body has to moderate of carbon dioxide levels.
Dependence on respirator [ventilator] status Z99. 11 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
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.
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.