[Music] ch ch [Music] [Music] [Music] ch [Music] [Music] oh [Music] [Music] section which is on sepsis yes sepsis is also very important uh part in the chapter one and it has got some guidelines as well to review so cus what is a sepsis a sepsis is a potential lifethreatening condition caused by body's response to an infection so what it happens it usually starts with a local in local uh infection and this infection will be caused by a bacteria so as you can see in the image which has been provided so so in the step two the bacteria will enter into the bloodstream and naturally what does the body do body will respond to that bacteria and our immune system will fight back the infection and in a worst case scenario the bacteria and immune cells might spread throughout the body and it will cause an uncontrolled inflammation which might lead to an even organ damage and even death if left unre so that is what sepsis all about and it is really a serious condition which requires a immediate medical attention so what is severe sepsis a severe sepsis is the sepsis with an acute organ dysfunction and what is a septic shock it is a form of an sever sepsis where organ dysfunction involves cardiovascular system so these are more severities of the sepsis so coming to our coding part underlying organism the sepsis and CVS is required to require a code to identify the systemic infection yes if you find a scenario on sepsis first thing which we have to look is whether the organism uh which caus the sepsis is known or not so if the organm is unknown we would code a 41.9 and if the organism is known it will depends on the last few characters the last two characters will depend uh will be specific for the uh infection which is C so a41 point the remaining two characters it will Define the organism that cause the sepsis and the guideline number is C1 T1 A3 so let's move on to the next guideline on S sepsis with acute organ function and this requires minimum of two codes and your sequency order is as follows code first the underlying organism as I said in the previous slide if the organism is known it would be a41 last two characters would be more specific for the organism and a 41.9 for asepsis unknown organism unknown ctive organism and the second code second code would be r65 5.2 Z would be for the c CVS sepsis without septic shock and r65.2 one would be for S sepis with septic shock so it depends upon the documentation and important thing for you all to note here is that uh this R 64.2 ICD is never sequenced first it would be sequenced only after uh the organism or the sepsis Cod and the third code for the organ dysfunction so if the as you can see the C sepsis with organ dysfunction acute organ dysfunction is a title so if the cious sepsis is with organ dysfunction the third code would be for the organ dysfunction that involved and the guideline for this is C1 d1b in your book ICD book now let's move on to the next guideline see D1 D2 setic shock with organ dysfunction and this one also required minimum of two quotes code first the underlying organism a41 or a 41.9 if organm is unknown code second r65.21 for septic shock once again r65.21 is not sequenced first it's never sequenced first uh the third code would be for the organ dysfunction or kidney failure if involved any kid if it involves any kidney failure and fourth code would be for any Associated organ dysfunction so these are the guidelines coding septic sepsis I'm sorry sepsis now I think it's time to test your knowledge on sepsis and and the related guideline so here we are having a question what code are assigned your options are a 41.9 r65.21 option b a 40.1 J1 15.3 r65.20 option C A 40.1 J1 15.3 option D A 41.9 J1 15.3 r65.21 a patient admitted to the hospital with stripto coal Group B pneumonia with severe sepsis what ICD codes are assigned so coders I would give you around two minutes to solve this scenario and we will be coming back and discussing the answers okay what is at time and I was having look into the chat to see your answers so I see that there's mix mixed response in the chat so this is going to be tach moment let's highlight the keywords for this scenario strepto coal groy pneumonia with sever sepsis so coders let me ask you a question what is the diagnosis which we are having the patient is having a severe sepsis and it's a strepto cocal B pneumonia with seious sepsis that's a final diagnosis with the patient is having so we are having a local infection as well so if you look into the guideline see 1 D4 it State sepsis or sever sepsis with a localized infection yes we are having a localized infection yes we are having a c sepsis as well under these condition what should we do the patient admitted for a sepsis with localized infection the underlying systemic infection is sequenced first then the loc localized infection then if if applicable the code for uh cvsis are 65 .20 and finally organ dysfunction so this is your sequencing order for this scenario so let me look is the sepsis type specified is organism specified or not let me have a look into the chat is organism the hi is organism costive organs mentioned in our scenario or not yes sir I see the answer so yes specified exactly so a 41.9 what is a 41.9 coding for a 41.9 is coding for a sepsis unspecified organism while in our scenario it's mentioned stal B pneumonia with s sepsis so the stral B Group B is the specified I'm sorry for my tone is a specified organism so a41 9 a 41.9 is the wrong answer so I can eliminate option A and option D here so that's El that's eliminated the remaining two options are B and C looking into the sequencing order now I have to code for the first for the sepsis with specified organism that would be a 40.1 yes sepsis due to streptococus Group B that's done what comes next next comes a localized infection and that would be pneumonia right j8 J 15.3 and what comes next yes over here next comes R 65.2 and we are also having a s sepsis in our scenario so that would be a 65.2 three and option C is not coding for csis while it was necessary because scenario states that we are having a strepto cocal Group B pneumonia with sever sepsis so the sequencing order would be a 40.1 J1 15.3 and r65.20 which is the code for C sepsis without septic shock how are you feeling about that one are you feeling good so code is always look and follow the sequencing guidelines never code r65.2 first as well so if you follow the sequencing guidelines you will reach into the correct answer okay so let's do some exercise here you can name the sepsis code which is going to come up in the next slide and I would give you one minute to pick up the ICD codes for these conditions and let's see Okay C your first exercise acute renal failure what is the ICD code for acute renal failure your time starts now yes I see the answers coming in the chat now it's n yes n 17.9 is the ICD code for aural filia now let's move on and let's try next one so sepsis non organism what is ICD 10cm code for sepsis known organism so I see few answers in the chat I'm expecting few more answers coming up come on coders let's make this exercise Interactive so there you go the answers are now coming so the sepsis known organism it is going to be a41 pointx depending upon type of organism that cause sepsis remember Cod so if the organism is known the last characters will Define the ICD code yeah yes so next one coming up as SE sepsis no o that is unspe severs is unspecified what is the ICD code yes icd10 CM code for csis unspecified is going to be our 6520 so that is what for cvsis and and specify yes next next task C sepsis with septic shock I repeat cious sepsis with septic shock that's okay take your time coders and answer back in the chat great work on this one I'm so happy seeing the responses so I I'm sure that you know what's the difference between CVSs without septic shock and CVSs with septic shock so r65.21 is ICD code for cvsis with septic shock for cvsis without septic shock it would be r65.20 great work coders I have few more for you sepsis unspecified if the organism is unknown what is ICD code for sepsis unspecified great work on this one as well coders so you are catching up now so great work the answers are flowing the correct answer for this is a 41.9 so if spe sepsis organism is unknown the code icd1 CM code for sepsis unspecified is going to be a 41.9 and if the organism is known it would be a41 the final two characters would be X and final character would be X and it depends upon the specific organism that caus the sepis so is it clear coders are you feeling good so far because I am going to bring up a scenario for you yes let's see let's see how are you all feeling about this one what is icd1 CM for the below scenario your options are option a a41.51 r65.20 option b a41.51 r65.20 r 68.8 3 r0 6.82 option C a41.51 R 68.8 3 r0 6.82 and option D a41.51 a patient arrives to the Ed with fever chills and Rapid breathing the Ed physician diagnos the patient with isaria kpsis so you have got two minutes to answer this one let's see after two minutes so job well done on this scenario as well and I feel like you all answer it pretty fast and it needed much time so the correct answer for this scenario is going to be option D and let's highlight the keywords fever chills rapid breathing and the Ed physician diagnos a patient with escario coli sepsis so what are we having here we are having the guideline C1 D1 a which say that yes requires minimum one code for coding the diagnosis of sepsis and what did the doctor uh diagnos the patient the doctor diagnos a patient with isaria colly sepsis so my question to you is qu this is the sepsis specified or unspecified okay okay so you all are saying it is specified exactly it is specified so what else is the patient having patient is only having E esia coli eoli sepsis is he having any severe sepsis or sever sepsis with septic shock yes it is not documented the patient is only having sepsis here exactly so following the guidelines like let's let's start eliminating the wrong answer let's look into the option A and B option A and B is coding for r65.20 and what is r65.20 from the exercises which we have done we know that r65.20 is coding for C severe sepsis without septic shock that's why I asked what the patient has been diagnosed with is the patient diagnosed with a severe sepsis no so there is no need to code for r65.20 in option A and option b so it's both are wrong and looking to the option C it is having uh it is coding for R 68.8 3 and r0 6.82 which is a code for chills without fever that is still unspecified so if we are having a Eco lipsis which has been diagnose do we need to code a chills fever rapid Brea uh rapid breathing coders do we need to code them separately no they are we don't need to code them separately exactly we don't need because they are signs and symptoms of the definity diagnosis which is equal ipsis so I can eliminate option C as well and the correct answer is option D a41.51 which is yes over here it is sepsis due to isaria coli which is eoline so option D is the correct answer so if I knew this guideline I knew the sequencing order I could have eliminated all A B A and C on site I would have easily picked option D so how are you feeling are you feeling confident on sepsis because we are okay I see feel good yes because we are now moving away from sees thanks for tuning in and until next time happy [Music] coding