Code | Diagnosis |
---|---|
A04.71 | Enterocolitis due to Clostridium difficile, recurrent |
A04.72 | Enterocolitis due to Clostridium difficile, not specified as recurrent |
All patients with a positive laboratory result for C. difficile (Bact+) and/or the ICD-10 discharge code for C. difficile infection, A04. 7, as principal or associated diagnosis (ICD10+), were identified.
One test shows whether bacteria are present, this is known as the PCR test. The other test shows the bacteria are producing toxins (poisons) in your gut. In patients who are PCR positive only for C difficile the bacteria are present but not producing toxins.
7.
The stool C difficile toxin test detects harmful substances produced by the bacterium Clostridioides difficile (C difficile). This infection is a common cause of diarrhea after antibiotic use.
Up to 50% of patients have positive C diff PCR for as long as six weeks after the completion of therapy.
A C. diff infection causes symptoms that range from mild diarrhea to life-threatening inflammation of the large intestine. It is especially dangerous to people with weakened immune systems. C.
19.
The International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9) code used in this study was 008.45, "intestinal infection due to Clostridium difficile," and is the only ICD-9 code related to CDAD.
Enterocolitis due to Clostridium difficile The 2022 edition of ICD-10-CM A04. 7 became effective on October 1, 2021.
Collect specimen in clean, watertight container. Transport media is not necessary and may increase false positive results. Transport specimens as soon as possible and store at 2 - 8 °C until tested. Storage at room temperature may decrease the sensitivity of some tests, possibly due to toxin inactivation.
Molecular assays can be positive for C. diff in individuals who are asymptomatic and do not have infection. Patients with other causes of diarrhea might be positive, which could lead to over-diagnosis and treatment.
The simplest way to detect C. difficile is through a stool test, in which you provide a sample in a sterile container given to you at your doctor's office or a lab. A pathologist, a doctor who studies diseases in a laboratory, determines whether the sample has signs of C. difficile.
Molecular assays can be positive for C. diff in individuals who are asymptomatic and do not have infection. Patients with other causes of diarrhea might be positive, which could lead to over-diagnosis and treatment.
C. diff spreads when people touch food, surfaces, or objects that are contaminated with feces (poop) from a person who has C. diff.
Antibiotics are the mainstay to treat C. difficile infection. Commonly used antibiotics include: Vancomycin (Vancocin HCL, Firvanq)
Retesting for C difficile is not recommended, particularly for molecular studies, as detection rates and results do not improve, and there is an associated increase in healthcare costs and the likelihood of false-positive findings.
Indication. DIFICID is a macrolide antibacterial drug indicated in adult and pediatric patients 6 months of age and older for treatment of Clostridioides difficile -associated diarrhea (CDAD).
Acute hypersensitivity reactions, including dyspnea, rash, pruritus, and angioedema of the mouth, throat, and face have been reported with DIFICID. If a severe hypersensitivity reaction occurs, DIFICID should be discontinued and appropriate therapy should be instituted.
DIFICID is a macrolide antibacterial drug indicated in adult and pediatric patients 6 months of age and older for treatment of Clostridioides difficile -associated diarrhea (CDAD).
DIFICID is contraindicated in patients who have known hypersensitivity to fidaxomicin or any other ingredient in DIFICID. Acute hypersensitivity reactions, including dyspnea, rash, pruritus, and angioedema of the mouth, throat, and face have been reported with DIFICID.
No dosage adjustments are recommended when co-administering fidaxomicin with substrates of P-gp or CYP enzymes.
Only use DIFICID for infection proven or strongly suspected to be caused by C. difficile. Prescribing DIFICID in the absence of a proven or strongly suspected C. difficile infection is unlikely to provide benefit to the patient and increases the risk of development of drug-resistant bacteria.
The 2021 edition of ICD-10-CM A04.7 became effective on October 1, 2020.
The 2022 edition of ICD-10-CM A04.7 became effective on October 1, 2021.
The 2022 edition of ICD-10-CM Z22.322 became effective on October 1, 2021.
Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00 -Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
2. Diarrhea secondary to acute gastroenteritis with negative Clostridium
The ELISA for toxin is known to have a super high rate of false negative tests.. Up to 75% of the time you can get a negative test for this even when the C. Diff is present
If the GDH Antigen is detected and the Toxin A and B are not detected or the GDH Antigen is not detected and the Toxin A and B are detected, Clostridium difficile Toxin B, Qualitative, Real-Time PCR will be performed at an additional charge (CPT code (s): 87493).
Collect fresh stool in sterile, leak-proof container without media, preservative, or metal ion. For patients requiring the use of diapers, first line the diaper with clean plastic to prevent absorption. Then transfer 5 grams or 5 mL of the stool specimen from the plastic lined diaper to the sterile container. Do not submit the diaper itself.
Formed stool • Stool submitted in transport media or swab • Rectal swab • Unfrozen stool >72 hours old • Received room temperature
Collect fresh stool in sterile, leak-proof container without media, preservative, or metal ion. For patients requiring the use of diapers, first line the diaper with clean plastic to prevent absorption. Then transfer 5 grams or 5 mL of the stool specimen from the plastic lined diaper to the sterile container.