ICD-10 Coding for Hypoxemia(R09.02, J96.01)
Complete ICD-10-CM coding and documentation guide for Hypoxemia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hypoxemia
R09.0-R09.89Primary Range
Other symptoms and signs involving the circulatory and respiratory systems
This range includes codes for symptoms related to respiratory conditions, including hypoxemia.
Respiratory failure, not elsewhere classified
This range includes codes for respiratory failure, which can include hypoxemia as a component.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R09.02 | Hypoxemia | Use when hypoxemia is documented without meeting criteria for acute respiratory failure. |
|
| J96.01 | Acute respiratory failure with hypoxia | Use when acute respiratory failure criteria are met, including hypoxemia. |
|
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 hypoxemia
Essential facts and insights about Hypoxemia
Primary ICD-10-CM Codes for hypoxemia
Decision Criteria
clinical Criteria
- PaO2 <60 mmHg without acute respiratory distress
coding Criteria
- Documented hypoxemia without meeting ARF criteria
Applicable To
- Low blood oxygen levels
Excludes
- Respiratory failure (J96.-)
Clinical Validation Requirements
- PaO2 <60 mmHg on room air
- SpO2 <91% on room air
Code-Specific Risks
- Incorrectly coding as respiratory failure when criteria are not met.
Coding Notes
- Ensure hypoxemia is not part of a larger condition like respiratory failure before coding R09.02.
J96.01 - Acute respiratory failure with hypoxia
Use when acute respiratory failure criteria are met, including hypoxemia.
Applicable To
- Acute hypoxemic respiratory failure
Excludes
- Chronic respiratory failure (J96.10-J96.12)
Clinical Validation Requirements
- PaO2 <60 mmHg with acute respiratory distress
- FiO2 ≥50% required
Coding Notes
Ensure documentation supports acute respiratory failure criteria.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hypoxemia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R09.02.
Impact
Clinical: Inaccurate clinical picture., Regulatory: Non-compliance with coding standards., Financial: Potential loss of reimbursement.
Mitigation Strategy
Always document and code the underlying condition first.
Impact
Reimbursement: Incorrect coding can lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use J96.01 when acute respiratory failure criteria are met.
Impact
Incorrect coding of respiratory failure can lead to audits.
Mitigation Strategy
Ensure documentation supports all criteria for respiratory failure.
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 Hypoxemia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hypoxemia
Use these documentation templates to ensure complete and accurate documentation for Hypoxemia. These templates include all required elements for proper coding and billing.
Acute hypoxemic respiratory failure
Specialty: PulmonologyRequired Elements
- Vital signs
- ABG results
- Oxygen therapy details
- Underlying condition
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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