Melissa Posted Tue 18th of June, 2013 14:05:54 PM
Pt has disseminated cutaneous herpes simplex 1, infected abdominal panniculus septic shock respiratior failure.
do I code herpes septicemia? Md. put septic shock due to above and above meaning the herpes simples 1 and the panniculus?
SuperCoder Answered Wed 19th of June, 2013 11:09:05 AM
If the documentation isn’t clear enough, you’ll need to query the physician. For instance, is the panniculus infection referring to the herpes virus? But here’s some information to work with:
ICD-9 official guidelines state:
“(a) Sequencing of septic shock and postprocedural septic shock
“Septic shock generally refers to circulatory failure associated with severe sepsis, and, therefore, it represents a type of acute organ dysfunction. For cases of septic shock, the code for the systemic infection should be sequenced first, followed by codes 995.92, Severe sepsis and 785.52, Septic shock or 998.02, Postoperative septic shock. Any additional codes for other acute organ dysfunctions should also be assigned. As noted in the sequencing instructions in the Tabular List, the code for septic shock cannot be assigned as a principal diagnosis.
“(b) Septic shock and postprocedural septic shock without documentation of severe sepsis
“Since septic shock indicates the presence of severe sepsis, code 995.92, Severe sepsis, can be assigned with code 785.52, Septic shock, or code 998.02 Postoperative shock, septic, even if the term severe sepsis is not documented in the record.”
So consider these codes in comparison to your documentation:
* Systemic infection: 054.5, Herpetic septicemia (054.5 translates to ICD-10 code B00.7, Disseminated herpesviral disease)
* Severe sepsis: 995.92
* Septic shock: 785.52
* Acute organ dysfunction: 518.81 - Acute respiratory failure