Health Information Management

Q&A: Query forms for acute and chronic respiratory failure

HIM-HIPAA Insider, July 16, 2012

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A: Consult AHA Coding Clinic for ICD-9-CM, Third Quarter 1988, p. 7, and Second Quarter 1990, pp. 20–21, for references stating that patients in acute respiratory failure do not require intubation. Note also that Murray and Nadel’s Textbook of Respiratory Medicine, Fourth Edition Vol. 2, includes the same arterial blood gas criteria for acute respiratory failure and does not require intubation.

I was a Coding Clinic panel participant and worked hard for the 1988 guidance. This allowed my performance profile to reflect hospital resources that I had to use to prevent intubation in my patients who had COPD and other respiratory illnesses. Back then, the peer review organization did not allow reporting of acute respiratory failure unless a patient was intubated, which not only poorly reflected on my profile but represented only the patients with severe acute respiratory failure who did not respond to noninvasive support. Note that Coding Clinic is not a medical text, but an official coding reference that you may find helpful.

Editor’s note: William E. Haik, MD, FCCP, CDIP, director of DRG Review, Inc., in Fort Walton Beach, Fla., answered this question, which originally appeared in CDI Strategies.
 



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