EmailACS 1614 and respiratory distress syndrome
Publication Date: February 2004
ICD 10 AM Edition: Third edition
Retired Date: 30/6/2010
Query Number: 1948
The third year students at LaTrobe University would appreciate clarification about the following issues. Neither the coding standards nor a search of the NCCH data base and the VICC newsletters has helped.
1. The following instruction appears in ACS 1614
The code for respiratory distress syndrome of newborn (P22.0 Respiratory distress syndrome of newborn) should be reserved to classify the condition of:
• hyaline membrane disease, or
• respiratory distress syndrome, or
• surfactant deficiency.
Respiratory distress unspecified
The term 'respiratory distress unspecified' should not be coded as such, as it is considered a symptom not a diagnosis. Further information regarding a definitive diagnosis should be sought from the clinician.
Does this mean that P22.0 cannot be assigned for 'respiratory distress' or does it mean that 'respiratory distress' cannot be coded at all. Some of us have coded 'respiratory distress' to P22.9
2. When coding premature neonates, should a code be assigned for the prematurity (P07.2- or P07.3-) as well as a code for the birth weight (P07.0- or P07.1-). The note on the tabular volume at P07 indicates that priority of assignment should be given to gestational age. We are unsure whether this means that both should be assigned with gestational age sequenced first, or that when you have both pieces of information you should only code the gestational age.
Search details:
ACS 1618 Prematurity and low birth weight
ACS 1614 Respiratory Distress Syndrome/Hyaline Membrane Disease/Surfactant Deficiency
1. The following instruction appears in ACS 1614
The code for respiratory distress syndrome of newborn (P22.0 Respiratory distress syndrome of newborn) should be reserved to classify the condition of:
• hyaline membrane disease, or
• respiratory distress syndrome, or
• surfactant deficiency.
Respiratory distress unspecified
The term 'respiratory distress unspecified' should not be coded as such, as it is considered a symptom not a diagnosis. Further information regarding a definitive diagnosis should be sought from the clinician.
Does this mean that P22.0 cannot be assigned for 'respiratory distress' or does it mean that 'respiratory distress' cannot be coded at all. Some of us have coded 'respiratory distress' to P22.9
2. When coding premature neonates, should a code be assigned for the prematurity (P07.2- or P07.3-) as well as a code for the birth weight (P07.0- or P07.1-). The note on the tabular volume at P07 indicates that priority of assignment should be given to gestational age. We are unsure whether this means that both should be assigned with gestational age sequenced first, or that when you have both pieces of information you should only code the gestational age.
Search details:
ACS 1618 Prematurity and low birth weight
ACS 1614 Respiratory Distress Syndrome/Hyaline Membrane Disease/Surfactant Deficiency
Response
Answer 1: The phrase 'should not be coded as such' in this standard should be interpreted as 'should not be coded as respiratory distress syndrome'.
The Committee recommends that coders look for a more specific respiratory symptom than 'respiratory distress', e.g. P28.83 Grunting in newborn, and only use 'P22.9 Respiratory distress of newborn, unspecified' when there is nothing else documented.
Answer 2: The Committee confirms that a code for both gestational age (sequenced first), and low birth weight should be assigned for premature infants, where applicable.
The Committee recommends that coders look for a more specific respiratory symptom than 'respiratory distress', e.g. P28.83 Grunting in newborn, and only use 'P22.9 Respiratory distress of newborn, unspecified' when there is nothing else documented.
Answer 2: The Committee confirms that a code for both gestational age (sequenced first), and low birth weight should be assigned for premature infants, where applicable.
