Coding, Classification & Reimbursement

1.  Bacteremia and Localized Infection

Posted 10-30-2017 12:33
Hello,

When coding bacteremia a localized infection, would the bacteremia be coded as an additional secondary diagnosis?

Example:  Patient admitted and found to have bacteremia due to a tunneled line.  In this case, the complication code for the line infection would be PDX.  Would an additional code be added for the bacteremia as this is denoted to be a symptom code in Chapter 18 and there is a definitive infection noted?

Thanks
Sheretta

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Sheretta Anderson

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2.  RE: Bacteremia and Localized Infection

Posted 10-30-2017 13:14

I would query to see if the patient had sepsis with the bacteremia..or if the bacteremia was just a lab finding of positive culture..

 

Sharon Hekimian, RHIT CCS                                                                

HIM Coder

PH #  781-453-5215

HOME OFFICE  # 617-312-9205

FAX # 781-453-5783 ATTN: SHARON

 






3.  RE: Bacteremia and Localized Infection

Posted 10-31-2017 11:07
Dear Sheretta,

Based on your post I do not see why bacteremia can not be the PDx. Is there something that is missing?

Jodi Miller, RHIT, CCS

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Jodi Miller, RHIT, CCS
Outpatient Coder/Abstractor
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4.  RE: Bacteremia and Localized Infection

Posted 10-31-2017 22:21
I would assign the bacteremia as an additional code. There is an ICD-9 Coding Clinic that advises to code both the infection of the line and the bacteremia. Sorry, I don't have access to Coding Clinic right now so I can't say which one it is. 

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Ashley Sparks
HIM Coding Quality Coordinator
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5.  RE: Bacteremia and Localized Infection

Posted 21 days ago
​Hello!

In your example, as you stated the complication code for a line infection must be sequenced first.  That is a Coding Guideline.  The complication code specific to Bloodstream infection would be used (T80.211).  There is a Use additional code instruction associated with the T80.2 subcategory.  Either sepsis or bacteremia may be added as an additional code.  Without seeing the actual record or knowing if CDI already issued a query, I cannot be certain which condition should be added.  It has been my experience lately that physicians document "bacteremia" when they mean "bacteremia", a bloodstream infection that does not meet the definition of "sepsis".  However, whatever the additional code assigned ends up being, the complication code must be sequenced first.

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Lawrence Barr
President
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