What is Respiratory Failure?
Respiratory failure is a condition in which there is insufficient oxygen passing from the lungs into the blood. The body’s organs, such as the heart and brain, need oxygen-rich blood to function well. One reason may be that the lungs cannot properly remove carbon dioxide from the blood. Too much carbon dioxide in the blood can harm the functions of the body’s organs. Both of these problems, a low oxygen level and a high carbon dioxide level in the blood, can occur simultaneously. Acute respiratory failure develops quickly and may require emergency treatment.
Signs and symptoms of Respiratory Failure include:
Shortness of breath,
Rapid breathing and hunger for air.
In severe cases, signs and symptoms may include a bluish color on the skin, lips, and fingernails; confusion; and sleepiness.
Chronic respiratory failure: It is very common in patients with severe COPD and other chronic lung diseases such as cystic fibrosis and pulmonary fibrosis. It is characterized by a combination of hypoxemia, elevated pCO2, elevated bicarbonate level, and normal pH (7.35 – 7.45). The most important to chronic respiratory failure is chronic dependence on supplemental oxygen.
Acute or chronic respiratory failure is a condition when an acute exacerbation, acidic carbon dioxide (CO2) may accumulate rapidly (CO2 retention), causing acidosis with a pH < 7.35 (acute hypercapnic respiratory failure). This would be worsening of the symptoms requiring an increase in supplemental oxygen also indicating an acute exacerbation of chronic respiratory failure.
Wikipedia article on Respiratory Failure.
ICD-10 coding for Acute Respiratory Failure:
Principal diagnosis:
A code from subcategory J96.0 Acute respiratory failure, or subcategory J96.2 Acute and chronic respiratory failure, may be assigned as a principal diagnosis when it is the condition established after study to be chiefly responsible for occasioning the admission to the hospital and depending on the circumstances of the admission. However, chapter-specific coding guidelines (such as obstetrics, poisoning, HIV, and newborns) that provide sequencing direction take precedence.
Secondary diagnosis:
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 the principal diagnosis.
Sequencing of acute respiratory failure and another acute condition: When a patient is admitted with respiratory failure and another acute condition, (e.g., myocardial infarction, cerebrovascular accident, aspiration pneumonia), the principal diagnosis will not be the same in every situation. This applies whether the other acute condition is a respiratory or non-respiratory condition. Selection of the principal diagnosis will be dependent on the circumstances of admission. If both the respiratory failure and the other acute condition are equally responsible for occasioning the admission to the hospital and there are no chapter-specific sequencing rules, the guideline regarding two or more diagnoses that equally meet the definition for principal diagnosis may be applied in these situations.
Respiratory failure is a life-threatening situation that is caused by underlying conditions such as diseases of the circulatory system, respiratory system, central nervous system, and respiratory muscles. The primary goal of the treatment of acute respiratory failure is to assess the severity of the underlying disease and to correct oxygen deficiency. With other conditions, if the documentation is not clear, then the provider should be queried for the same.
This is the link to the Respiratory Failure ICD10 codes on FreeMedicalCoding.com.