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A patient may be considered to be in acute respiratory failure (ARF) when
they have low arterial oxygen levels or elevated levels of carbon dioxide
gas or a combination of both. Although lab results and related
documentation (hypoxemia, acute respiratory insufficiency, or acute
respiratory distress) can be helpful in determining when to query the
physician about a diagnosis of acute respiratory failure; the physician
ultimately makes the final decision.
Underlying conditions associated with acute respiratory failure are
identified below:
Remember: The absence of intubation and mechanical ventilation does
not rule out the diagnosis of acute respiratory failure, 518.81 (ICD-9 CM)
and J96.00-.02 (ICD-10 CM) (AHA Coding Clinic, 3rd
Qtr, 1988, p. 7).
Imminent (about to happen) respiratory failure is not assigned a code.
Respiratory failure is not coded unless it occurs (AHA Coding Clinic, 2nd
Qtr, 2002, p. 6).
COPD; Asthma; Bronchiectasis; Cystic Fibrosis; Bronchiolitis
Inhaled Foreign Bodies; Obesity, Sleep Apnea, Hypothyroidism
Drug/Alochol Intoxication; Myasthenia Gravis, Polio; Burns
Guillain-Barre; Polymyositis, Certain Strokes; ALS; ARDS
Spinal Cord Injury; Pneumonia; Pulmonary Edema; Radiation
Widespread Tumors; Drug Reaction; Pulmonary Fibrosis
Sarcoidosis; Scoliosis; Chest Wound; Extreem Obesity; Surgery
CAUSES OF ACUTE RESPIRATORY FAILURE
WHAT TO EXPECT
1 Causes of Acute
Respiratory Failure
2 When Should It Be The
Principal Diagnosis?
3 Acute Respiratory Failure
as a Secondary Diagnosis
4 Requests for Coding Topics
Apri l 2015
Volume 2 Issue 4
By Cynthia Brown, MBA, RHIT, CCS
www.cyntcodinghealthinformationservices.com
CCHIS, P.O. Box 3019, Decatur, GA 30031 404-992-8984 http://www.cyntcodinghealth informationserv ices.com Cynth ia@cyntcodinghealthinformat ionserv ices.com [phone]
CODING YESTERDAY’S NOMENCLATURE TODAY®
CODING ACUTE RESPIRATORY FAILURE
(ICD-9 CM & ICD-10 CM)
CODING NEWSLETTER FOR HEALTHCARE
CODING PROFESSIONALS
Page 2 Coding Yesterday’s Nomenclature Today
Codes 518.81 (ICD-9 CM) and J96.00-.02 (ICD-10 CM) may be assigned
as the principal diagnosis when it is the condition established after study to
be chiefly responsible for occasioning the admission to the hospital and if
the selection is supported by the Alphabetic Index and Tabular List for both
nomenclatures. It should not however override the guidelines for obstetrics,
HIV, poisoning, newborn and other guidelines that have sequencing
priority. The following circumstances also apply:
Remember: ARF can also be the principle diagnosis when the reason for
the ARF is not known but is found to be the reason for admission; and when
ARF is the result of an adverse effect to a drug.
Remember: If the documentation is not clear as to whether acute
respiratory failure and another condition are equally responsible for
occasioning the admission, query the providers for clarification.
www.cyntcodinghealthinformationservices.com
ARF with Congestive Heart Failure (CHF) ; if found to be reason for admission
518.81 & 428.0 J96.00 & I50.9
ARF with acute exacerbation of chronic myasthenia gravis; If found to be reason for admission
518.81 & 358.01 J96.00 & G70.01
ARF with Asthma with status asthmaticus
518.81 & 493.91 J96.00 & J45.902
ARF and Myocardial Infarction; both meet the definition of principal diagnsis
518.81 & 410.91 or 410.91 & 518.81 J94.00 & I21.3 or I21.3 & 518.81
ARF and Pneumonia
518.81 & 486 J96.00 & J18.9
ARF with Emphysema
518.81 & 492.8 J96.00 & J43.9
“Not sure…then Query the
Physician”
Physician
documentation is the
key
When should it be the Principal Diagnosis?
Coding Yesterday’s Nomenclature Today
ACUTE RESPIRATORY FAILURE AS A 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 or if chapter specific guidelines specify that it should
be listed as a secondary diagnosis (obstetrics, HIV, sepsis).
CCHIS has two e-books you may find useful Coding Sepsis, Septicemia, SIRS,
Severe Sepsis & Septic Shock and ICD-9 CM & ICD-10 CM Obstetrics Coding both for the low price of $2.50 each. Thank you in advance for your purchase.
ARF due to Pneumocystis carinii
042 & 518.81; 136.3 B20 & J96.00; B59
Postpartum pulmonary emoblism with ARF
673.24 & 518.81 O88.23 & J96.00
Overdose on crack with acute respiratory failure
970.81 &518.81 T40.5X1A & J96.00
Acute Repiratory Failure of Newborn
770.84 P28.5
Patient admitted for exacerbated COPD; but later develops ARF
491.21 & 518.81 J44.1; J96.00
Severe Staphylococcus aureus sepsis and ARF
038.11; 995.92 & 518.81 A41.01;R65.20 & J96.000
AHIMA approved ICD-10 CM/PCS
Trainer
ALL THINGS CODING®
“Accurate and
complete coding is a
must in today’s
economically
challenged healthcare
environment.”
Page 4 Coding Yesterday’s Nomenclature Today
CCHIS Professional Affiliates
AHIMA GHIMA AHIMA approved ICD-10 CM/PCS
Trainer EDWOSB/WOSB VOSB SCORE Atlanta
CyntCoding Health Information Services P.O. BOX 3019 Decatur, GA 30031
Phone: 404-992-8984
E-Fax: 678-805-4919
E-mail: [email protected]
Requests for coding topics: E-mail your coding topics or request your FREE issue of the CCHIS Newsletter by visiting the website and leaving your contact information. You may also contact me at: [email protected].
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