EmailUTI due to suprapubic catheter
Publication Date: September 2021
Implementation Date: 1/10/2021
ICD 10 AM Edition: Eleventh Edition
Query Number: 3796
Recently we had a patient discharged with the diagnosis ‘urinary tract infection due to suprapubic catheter’. We are not sure how to code this condition.
Initially we followed the index entry:
Complication(s)/catheter (device) NEC/urinary (indwelling) - see Complication(s)/urethral catheter (indwelling)/ infection or inflammation, and assigned T83.5 Infection and inflammatory reaction due to prosthetic device, implant and graft in urinary system.
However, in ACS 1904 Procedural complications, Example 13, a leaking gastrostomy tube is coded to K91.43 Leak from stoma of the digestive system. The example then states that ‘a gastrostomy tube is a digestive system stoma, not a prosthetic device, implant or graft’.
Does the same logic apply for a suprapubic catheter and other tubes/catheters of stomas? (i.e. is an infection due to a suprapubic catheter a complication of the catheter, or a complication of the stoma?).
Can the committee please advise what complication and external cause codes should be assigned for urinary tract infection due to suprapubic catheter’?
Initially we followed the index entry:
Complication(s)/catheter (device) NEC/urinary (indwelling) - see Complication(s)/urethral catheter (indwelling)/ infection or inflammation, and assigned T83.5 Infection and inflammatory reaction due to prosthetic device, implant and graft in urinary system.
However, in ACS 1904 Procedural complications, Example 13, a leaking gastrostomy tube is coded to K91.43 Leak from stoma of the digestive system. The example then states that ‘a gastrostomy tube is a digestive system stoma, not a prosthetic device, implant or graft’.
Does the same logic apply for a suprapubic catheter and other tubes/catheters of stomas? (i.e. is an infection due to a suprapubic catheter a complication of the catheter, or a complication of the stoma?).
Can the committee please advise what complication and external cause codes should be assigned for urinary tract infection due to suprapubic catheter’?
Response
VICC’s research indicates that cystostomy and suprapubic catheter (SPC) are synonymous terms and are considered a urinary stoma in ICD-10-AM.
Therefore, VICC does not consider it is correct to follow Index entries Complication(s) (from) (of)/catheter (device) NEC/urinary (indwelling) – see Complication(s)/urethral catheter (indwelling) or Complication(s) (from) (of)/urethral catheter (indwelling) NEC/infection or inflammation T83.5 for documentation of infection due to suprapubic catheter (SPC)/cystostomy. VICC notes T83.5 Infection and inflammatory reaction due to prosthetic device, implant and graft in urinary system would be assigned for infection of an indwelling catheter.
The correct code to assign is N99.52 Infection of stoma of urinary tract, following the Index entry Complication(s) (from) (of)/cystostomy (catheter) (stoma) (tube) NEC/infection. VICC notes that catheter, stoma and tube are non-essential modifiers at this Index entry.
This is in accordance with ACS 1904 Procedural complications which states 'where a condition is not related to a prosthetic device, implant or graft and it is related to a body system, assign an appropriate code from the body system chapter' and is supported by Example 13 in ACS 1904 Procedural complications where a gastrostomy tube is noted to be a digestive system stoma and not a prosthetic device, implant or graft.
VICC also advises to assign N39.0 Urinary tract infection, site not specified to add specificity of the condition.
The correct external cause code to assign is Y83.36 Surgical operation with formation of external stoma, cystostomy following Index entry External causes of injury/Complication(s) (delayed) (medical or surgical procedure) (of or following)/cystostomy.
Please also refer to VICC query #3654 Infection due to suprapubic catheter (SPC)/cystostomy.
Therefore, VICC does not consider it is correct to follow Index entries Complication(s) (from) (of)/catheter (device) NEC/urinary (indwelling) – see Complication(s)/urethral catheter (indwelling) or Complication(s) (from) (of)/urethral catheter (indwelling) NEC/infection or inflammation T83.5 for documentation of infection due to suprapubic catheter (SPC)/cystostomy. VICC notes T83.5 Infection and inflammatory reaction due to prosthetic device, implant and graft in urinary system would be assigned for infection of an indwelling catheter.
The correct code to assign is N99.52 Infection of stoma of urinary tract, following the Index entry Complication(s) (from) (of)/cystostomy (catheter) (stoma) (tube) NEC/infection. VICC notes that catheter, stoma and tube are non-essential modifiers at this Index entry.
This is in accordance with ACS 1904 Procedural complications which states 'where a condition is not related to a prosthetic device, implant or graft and it is related to a body system, assign an appropriate code from the body system chapter' and is supported by Example 13 in ACS 1904 Procedural complications where a gastrostomy tube is noted to be a digestive system stoma and not a prosthetic device, implant or graft.
VICC also advises to assign N39.0 Urinary tract infection, site not specified to add specificity of the condition.
The correct external cause code to assign is Y83.36 Surgical operation with formation of external stoma, cystostomy following Index entry External causes of injury/Complication(s) (delayed) (medical or surgical procedure) (of or following)/cystostomy.
Please also refer to VICC query #3654 Infection due to suprapubic catheter (SPC)/cystostomy.
