Answer ICD-10: P36.30, Sepsis of newborn due to unspecified staphylococci
Answer ICD-9: 771.81
To locate P36.30: Index > sepsis > newborn > due to > Staphylococcus
In ICD-9-CM, two codes are required to capture neonatal septicemia and the bacterial infection. In ICD-10-CM, the combination code, P36.30, captures both infantile sepsis and the bacterial pathogen.
Sepsis is caused by the immune system’s response to a serious infection, most commonly bacteria, but also fungi, viruses, and parasites in the blood, urinary tract, lungs, skin, or other tissues. Sepsis can be thought of as falling within a continuum from infection to multiple organ dysfunction syndrome.
ICD-10-CM PDx: P29.3 (Persistent fetal circulation)
ICD-9-CM PDx: 747.83
Pxs: 0BH17EZ (Insertion of endotracheal airway into trachea, via natural or artificial openining)
5A1945Z (Respiratory ventilator, 24-96 consecutive hours)
- P29.3: Index > Persistent > fetal > circulation
In persistent fetal circulation a newborn baby’s circulation changes back to the circulation of a fetus, where much of the blood flow bypasses the lungs. During pregnancy, the fetal lungs are not used to exchange oxygen and carbon dioxide, so the lungs need less blood supply. The fetal circulation sends most of the blood supply away from the lungs through special connections in the heart and the large blood vessels. When a baby begins to breathe air at birth, this fetal circulation changes dramatically. The change in pressure in the lungs helps close the fetal connections and redirect the blood flow. Now blood is pumped to the lungs to help with the exchange of oxygen and carbon dioxide.
- P29.11: Index > Tachycardia > newborn
- P28.2: Index > Attack > cyanotic, newborn
- 0BH17EZ: Px index > Intubation > Airway > see Insertion of device in, trachea > 0BH1 > locate table 0BH and go across the row to complete the code:
Insertion of endotracheal airway into trachea, via natural or artificial opening:
Always verify the 4th character value as you go across the row, making sure you always stay within the same row. Some tables are very lengthy, taking up 2, 3, or 4 pages in the ICD-10-PCS coding book. It is easy to forget this and assume there is no code for a particular procedure. If you keep going and turn the page, you’ll see that many of the tables are a continuation from the previous page.
- 5A1945Z: Px index > Performance > Respiratory > 24-96 consecutive hours, Ventilation > 5A1045Z. Even though the index gives you the code, it is still a good idea to review it to understand the structure:
Respiratory ventilator, 24-96 consecutive hours:
The 5th character in the Extracorporeal Assistance and Performance section is the Duration value. Duration describes whether the procedure was performed on a single or multiple occasions. For respiratory assistance and mechanical ventilation (respiratory performance), the specific time range available for coding is the Duration value. The 6th character in this section is the Function value and Ventilation is the function performed in Extracorporeal Assistance and Performance procedures.
How do you go about finding the right table in the index? I doubt that most of us would go to Performance, but that is where you’ll find the code. Performance is defined in ICD-10-PCS as completely taking over a physiological function by extracorporeal means. If you refer to the main term, Assistance, Respiratory, the subterms lead you to table 5A0. It isn’t the correct table, but it puts you in the right part of the book. The table directly below 5A0 is 5A1, and that is where you want to be. I’ve been telling you to rely on the index, but every now and then you’re going to have to do some searching and this is a good example of when ICD-10-PCS can be a challenge.
A ventilator blows air into your airways through the endotracheal tube. One end of the tube is inserted into the trachea and the other end is attached to the ventilator. The endotracheal tube serves as an airway by letting air and oxygen from the ventilator flow into your lungs.