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ICD-9 Respiratory

From coding guidelines Section I.8

What are the conditions that compise COPD Obstructive chronic bronchitis and emphysema
T/F Code 496, Chronic airway obstruction, not elsewhere classified, is a nonspecific code that should only be sed when the documentation in a medical record does not specify the type of COPD being treated True - if they list COPD in parts of the record and emphysema in other parts then you only code the emphysema as it is a type of COPD
What is an acute exacerbation of a condition? It is a worsening ora decompensation of a chronic condition. It is NOT equivelant to an infection superimposed on a chronic condition, though an exacerbation may be triggered by an infection.
T/F - an acute exacerbation is the same thing as status asthmaticus False - an acute exacerbation is an increased severity of the asthma symptoms, like wheezing and sob, while status asthmaticus refers to a patient's failure to respond to therapy administered during an asthma episode and is a life threatening complication
T/F If status asthmaticus is documented by the provider with any type of COPD or with acute bronchitis, the status asthmaticus should be sequenced first True - it supercedes any type of COPD including that with acute exacerbation or acute bronchitis.
T/F - if a patient is documented as having an acute exacerbation of asthma and status asthmaticus, you would assign an asthma code with 5th digit 2 (with acute exacerbation) together with an asthma code with 5th digit 1, with status asthmaticus. False - only the 5th digit 1 should be assigned.
T/F - when acute bronchitis is documented with COPD, you need a code for both False - you assign the combination code 491.22, Obstructive chronic bronchitis with acute bronchitis, only - this covers all conditions.
T/F - If a patient has acute bronchitis and COPD exacerbation, assign a code only for the COPD exacerbation as that superseeds acute bronchitis False - the acute bronchitis included in code 491.22 superceeds the acute exacrbation. If the pt has COPD exacerbation without acute bronchitis then use code 491.21
T/F - Code 518.81, Acute respiratory faiure should be assigned as the pdx if it is the condition established, after study, to be chiefly responsible for having occasioned admission to the hosiptal True - with the exception of specific rules governing obstetrics, poisoning, HIV, and newborns
T/F - 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 True
T/F - When a patient is admitted with respiratory failure and another acute condition (like MI, or CVA or pneumonia, the pdx will not always be the same - it will depend on the circumstances of admission True - Respiratory failure use to have other rules as to how it was listed as pdx, but the rules now state to follow the PDX definition - focus on this!
Created by: tccchar