Coding, Classification & Reimbursement

1.  Urinary tract infection caused by nontyphoidal Salmonella

Posted 6 days ago
​​Hi there Coding Community,
I need some advice on how to code a Urinary tract infection caused by nontyphoidal Salmonella.  Salmonella infections seem to be in a class of their own, but is a UTI with gram negative bacteria more appropriate?  I also notice a new code for Salmonella Pyelonephritis, but that doesn't quite fit either.

Thanks in advance,

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Cassandra Sweat, RHIA, CPHQ, CCS, CPC
cassandra.sweat@gmail.com
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2.  RE: Urinary tract infection caused by nontyphoidal Salmonella

Posted 3 days ago
Dear Cassandra,

I did some research on nontyphoidal salmonella, but I was unable to find if it is a gram negative bacteria or not. I would suggest that you find out before coding further.

Good Luck

Jodi Miller, RHIT, CCS

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Jodi Miller, RHIT, CCS
Outpatient Coder/Abstractor
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3.  RE: Urinary tract infection caused by nontyphoidal Salmonella

Posted 2 days ago


Thank you so much for your response Jodi.  I should have been more specific...
I see a code A02.29 for Salmonella w/Other Localized Infection and am also aware of using the UTI code N39.0 w/an additional code to identify the bacteria.  I am not sure which one to use here, or if both should be used. And if both are used which should be sequenced first-A02.29 or N39.0?  What do you all think?



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Cassandra
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4.  RE: Urinary tract infection caused by nontyphoidal Salmonella

Posted 2 days ago
Edited by James Schumer 2 days ago

Cassandra & Jodi,

According to the WHO, it's definitely Gram Negative Bacteria. (see below)

Given the information provided, and going with the "code also" guidelines, etiology followed by manifestation would be the correct sequencing of the two codes.

Hope this was helpful! = )


Ref: Salmonella (non-typhoidal

http://www.who.int/mediacentre/factsheets/fs139/en/


Salmonella (non-typhoidal)

Fact sheet
Reviewed September 2017


Key facts

  • Salmonella is 1 of 4 key global causes of diarrhoeal diseases.
  • Most cases of salmonellosis are mild; however, sometimes it can be life-threatening. The severity of the disease depends on host factors and the serotype of Salmonella.
  • Antimicrobial resistance is a global public health concern and Salmonella is one of the microorganisms in which some resistant serotypes have emerged, affecting the food chain.
  • Basic food hygiene practices, such as "cook thoroughly", are recommended as a preventive measure against salmonellosis.

Overview

The burden of foodborne diseases is substantial: every year almost 1 in 10 people fall ill and 33 million of healthy life years are lost. Foodborne diseases can be severe, especially for young children. Diarrhoeal diseases are the most common illnesses resulting from unsafe food, 550 million people falling ill each year, including 220 million children under the age of 5 years. Salmonella is 1 of the 4 key global causes of diarrhoeal diseases.

Salmonella is a gram negative rods genus belonging to the Enterobacteriaceae family. Within 2 species, Salmonella bongori and Samonella enterica, over 2500 different serotypes or serovars have been identified to date. Salmonella is a ubiquitous and hardy bacteria that can survive several weeks in a dry environment and several months in water.



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James Schumer
CCS-P
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