Back to HomeBeta

ICD-10 Coding for Acute Hypoxia(J96.01, J96.21)

Complete ICD-10-CM coding and documentation guide for Acute Hypoxia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Acute Hypoxemic Respiratory FailureAcute Respiratory Failure with Hypoxia

Quick Navigation

Related ICD-10 Code Ranges

Complete code families applicable to Acute Hypoxia

J96.0-J96.2Primary Range

Acute and chronic respiratory failure

This range includes codes for acute and chronic respiratory failure, crucial for coding acute hypoxia.

J80

Acute respiratory distress syndrome (ARDS)

ARDS is a differential diagnosis for acute hypoxia and requires different coding.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
J96.01Acute respiratory failure with hypoxiaUse when acute hypoxia is the primary issue without chronic components.
  • PaO₂ <60 mmHg or SpO₂ ≤90%
  • Respiratory distress (e.g., RR >20, accessory muscle use)
J96.21Acute and chronic respiratory failure with hypoxiaUse when acute hypoxia occurs on top of a chronic respiratory condition.
  • Chronic baseline condition (e.g., COPD) with acute hypoxia
  • PaO₂ <60 mmHg or SpO₂ ≤90% during exacerbation

Clinical Decision Support

Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.

Key Information: ICD-10 code for acute hypoxia

Essential facts and insights about Acute Hypoxia

The ICD-10 code for acute hypoxia is J96.01, used for acute respiratory failure with hypoxia.

Primary ICD-10-CM Codes for acute hypoxia

J96.01
Acute respiratory failure with hypoxia
Billable Code

Decision Criteria

clinical Criteria

  • Presence of acute hypoxia with documented respiratory distress

documentation Criteria

  • ABG or SpO₂ values meeting hypoxia criteria

Applicable To

  • Acute hypoxemic respiratory failure

Excludes

Clinical Validation Requirements

  • PaO₂ <60 mmHg or SpO₂ ≤90%
  • Respiratory distress (e.g., RR >20, accessory muscle use)

Code-Specific Risks

  • Misclassification if chronic component is present
  • Inadequate documentation of hypoxia criteria

Coding Notes

  • Ensure documentation specifies acute onset and hypoxia criteria.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

COPD with acute exacerbation

J44.1
Use when acute hypoxia occurs in the context of COPD exacerbation.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Acute respiratory distress syndrome

J80
Bilateral infiltrates on CXR and PaO₂/FiO₂ ≤300 mmHg

Acute respiratory failure with hypoxia

J96.01
No chronic respiratory condition present

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Acute Hypoxia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code J96.01.

Impact

Clinical: Misrepresentation of patient's condition., Regulatory: Non-compliance with ICD-10 guidelines., Financial: Potential for denied claims.

Mitigation Strategy

Always document the chronic baseline if present., Clarify acute onset in documentation.

Impact

Reimbursement: Incorrect coding may lead to lower DRG assignment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate representation of patient condition.

Mitigation Strategy

Use J96.21 when a chronic condition is present.

Impact

Failure to document specific hypoxia criteria can lead to audits.

Mitigation Strategy

Ensure ABG or SpO₂ values are documented with clinical signs.

Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.

Frequently Asked Questions

Common questions about ICD-10 coding for Acute Hypoxia, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Acute Hypoxia

Use these documentation templates to ensure complete and accurate documentation for Acute Hypoxia. These templates include all required elements for proper coding and billing.

Acute hypoxia in emergency department

Specialty: Emergency Medicine

Required Elements

  • SpO₂ values
  • Respiratory rate
  • Use of accessory muscles
  • Underlying cause

Example Documentation

Patient presents with acute hypoxemic respiratory failure (SpO₂ 82% on RA) due to pneumonia, requiring 6L NC.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient hypoxic, given oxygen.
Good Documentation Example
Acute hypoxemic respiratory failure (SpO₂ 82% on RA) secondary to pneumonia, requiring 6L NC to maintain SpO₂ >92%.
Explanation
The good example specifies the acuity, SpO₂ levels, and treatment required.

Need help with ICD-10 coding for Acute Hypoxia? Ask your questions below.

Ask about any ICD-10 CM code, or paste a medical note

We build tools for
clinician happiness.

Learn More at Freed.ai
Back to HomeBeta

Built by Freed

Try Freed for free for 7 days.

Learn more

Helpful Links

How ICD 10 AI Lookup WorksContact UsPrivacy Policy