Chapter 14

Front 1

When the reason for admission is both sepsis (or severe sepsis) and a localized infection (e.g., pneumonia or cellulitis), which condition should be assigned as the principal or first-listed diagnosis?

Back 1

Sepsis or severe sepsis

Front 2

What does the term "severe sepsis" refer to?

Back 2

Sepsis with associated acute or multiple organ dysfunction.

Front 3

What is a nosocomial infection?

Back 3

An infection contracted as a result of medical treatment

Front 4

How should an unconfirmed diagnosis of HIV infection be coded?

Back 4

It should not be coded as confirmed: this condition is an exception to the guideline for "possible", "probable" conditions.

Front 5

A bacterial infection originally reported almost exclusively in menstruating women using high absorbency tampons

Back 5

Toxic Shock Syndrome

Front 6

Systemic response to infection, trauma/burns, or other insult, with symptoms including fever, tachycardia, tachypnea, and leukocytosis

Back 6

SIRS

Front 7

Bacteremia is defined as

Back 7

Presence of bacteria in the bloodstream after trauma or infection.

Front 8

Which of the following transmits West Nile Fever to humans.

Back 8

Mosquitoes

Front 9

A patient is admitted due to sepsis from an immunization he received for shingles. What is the proper sequencing for these codes.

Back 9

Code the infection from immunization first followed by the sepsis code

Front 10

A patient is admitted due to cellulitis of the legs that is a complication of HIV infection. What is the proper sequencing of these diagnosis?

Back 10

Code the HIV infection code first then the cellulitis

Front 11

When a main term for a condition is located and there are subterms for acute or chronic and subterm for an organism specified in the diagnosis and the subterms are all at the same indention level, what is correct coding and sequencing?

Back 11

Only the code with the organism is coded

Front 12

Codes from chapter 1 take precedence over codes from other chapters for same condition.

Back 12

Codes from chapter 1 take precedence over codes from other chapters for same condition.

Front 13

Conditions that are not considered to be easily transmissible or communicable are classified in the appropriate body system chapter, with an additional...

Back 13

code from category B95-B97 to indicate the responsible organism.

Front 14

Chapter 1 ofICD-10-CM classifies infectious and parasitic diseases

Back 14

that are easily transmissible (communicable).

Front 15

The primary axis forthis chapter is the organism responsible for the condition.

Back 15

.

Front 16

Infectiousand parasitic conditions are classified in one of several ways, making carefuluse of the Alphabetic Index imperative.

Back 16

.

Front 17

A single code from chapter 1 is assigned to indicate the organism.

Back 17

For example, code B26.- is assigned for mumps.

Front 18

Some codes of this type use a fourth character to indicate a site or an associated condition.

Back 18

For example, code B37.1 is assigned for candidiasis of the lung.

Front 19

Combination codes frequently identify both the conditionand the organism

Back 19

For example: J15.212 Pneumonia due to Methicillin resistant Staphylococcus aureus B26.0 Orchitis due to mumps

Front 20

Dual classification is also used extensively for chapter 1.

Back 20

For example: B49 + J99 Bronchomycosis B39.9 + H32 Chorioretinitis in histoplasmosis

Front 21

Codes from chapter 1take precedence over codes from other chapters for the same condition.

Back 21

.

Front 22

Conditionsthat are not considered to be easily transmissible or communicable areclassified in the appropriate body system chapter, with an additional code fromcategory B95-B97 to indicate the responsible organism.

Back 22

.

Front 23

Whenthe main term for the condition has been located, a subterm for the organismalways takes precedence over a more general subterm (such as "acute"or "chronic") when both subterms occur at the same time the sameindention level in the Alphabetic Index.

Back 23

Forexample, for a diagnosis of chronic cystitis due to gonococcus, the AlphabeticIndex provides subterms for both chronic and genococcal. The subterm for theorganism takes precedence over the subterm "chronic".

Front 24

When the organism isspecified but is not indexed under the main term for the condition, the codershould refer to the main term Infection orto the main term for the organism.

Back 24

.

Front 25

Thisis a respiratory illness caused by a coronavirus, SARS begins with a fever andmay include chills, headache, and malaise. In some patient's, there are alsomild respiratory symptoms, dry cough, and trouble breathing.

Back 25

Z20.828 Contact exposure to SARS-associated coronavirus

B97.21 SARS-associated coronavirus infection

J12.81 Pneumonia due to SARS-associated coronavirus

Front 26

SubcategoryA92.3 is used to report West Nile virus infection.

Back 26

SubcategoryA92.3 is further subdivided to distinguish between West Nile virus infectionunspecified (A92.30), with encephalitis (A92.31), with other neurologicmanifestation (A92.32), and with other complications (A92.39).

Front 27

Late Effects: Chapter1 provides four sequelae categories for use when there is a residual conditiondue to previous infection or parasitic infestation:

Back 27

B90.0 Sequelae of tuberculosis

B91 Sequelae of poliomyelitis

B92 Sequelae of leprosy

B94 Sequelae of other and unspecified infectious and parasitic diseases

Front 28

Thecode for the residual effect is sequenced first, followed by the appropriatesequelae code,

Back 28

except in a few instances where the Alphabetic Index instructs otherwise.

Front 29

Acode for the infection itself is not assigned because it is no longer present.

Back 29

For example:

G93.9 + B94.1 Brain damage resulting from previous viral encephalitis (three years ago)

E35 + B90.8 Tuberculous calcification of adrenal gland

Front 30

TB is a bacterialdiseases caused by Mycobacterium tuberculosis and Mycobacterium bovis. It isspread through the air.

Back 30

Tuberculosis is classified to categories A15 through A19 based on the general site or type of TB.

Front 31

Categories A15, A17,and A18 are subdivided further to specify the site.

Back 31

TB usually affects the lungs (code A15.0), although other parts of the body also can be affected.

Front 32

Careshould be taken to differentiate between a diagnosis of tuberculosis and apositive TB test without a diagnosis of active TB.

Back 32

.

Front 33

Code R76.11classifies the following:

Back 33

Nonspecific reaction to TB skin test without active TB

Positive TB skin test without active TB

Positive PPD (skin test)

Abnormal result of Mantoux test

TB (skin test) positive

TB (skin test) reactor

Front 34

For a diagnosis of sepsis, the appropriate code for the underlying systemic infection should be assigned.

Back 34

.

Front 35

A diagnosis of sepsis can neither be assumed nor ruled out on the basis of laboratory values alone.

Back 35

Query the provider if diagnosis in question.

Front 36

Bacteremia refers to the presence of bacteria in the bloodstream after trauma or mild infection.

Back 36

This condition is usually transient and ordinarily clears promptly through the action of the body's own immune system.

Front 37

Urosepsis refers to pyuria or bacteria in the urine, not the blood.

Back 37

Should not be considered synonymous with sepsis.

Front 38

Urosepsis is sometimes stated as the diagnosis even though the condition has progress to sepsis.

Back 38

It has no default code in the Alphabetic Index

Front 39

Systemic inflammatory response syndrome (SIRS) generally refers to the systemic response to infection, trauma/burns, or other insult (such as cancer), with symptoms

Back 39

including fever, tachycardia, tachypnea, and leukocytosis.

Front 40

Severe sepsis generally refers to sepsis with associated acute or multiple organ dysfunction.

Front 41

Septic shock generally refers to circulatory failure associated with severe sepsis and therefore represents a type of acute organ dysfunction.

Back 41

The physician must specifically record septic shock in the diagnostic statement in order to code it as such.

Front 42

Coding of sepsis requires a minimum of two codes:

Sequence first a code for the underlying infection followed by a code form subcategory R65.2 Severe sepsis

Back 42

If the causal organism is not documented, assign code A41.9, Sepsis, unspecified organism, for the infection.

An additional code(s) should also be assigned for the associated acute organ failure

Front 43

If severe sepsis is present on admission and meets the UHDDS definition of principal diagnosis, that is, the condition after study that necessitated the admission, assign first the code for the underlying systemic infection,

Back 43

followed by the appropriate code from subcategory R65.2 as required by the sequencing rules in the Tabular List. A code from subcategory R65.2 can never be assigned as a principal diagnosis.