ICD-10 Coding for Hypoxemic Respiratory Failure(J96.01)
Complete ICD-10-CM coding and documentation guide for Hypoxemic Respiratory Failure. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hypoxemic Respiratory Failure
J96.0-J96.9Primary Range
Respiratory failure, not elsewhere classified
This range includes codes for acute and chronic respiratory failure, including hypoxemic and hypercapnic types.
Key Information: ICD-10 code for acute hypoxemic respiratory failure
Essential facts and insights about Hypoxemic Respiratory Failure
Primary ICD-10-CM Code for hypoxemic respiratory failure
Decision Criteria
clinical Criteria
- Documented pO₂ <60 mmHg or SpO₂ <91%
documentation Criteria
- Linkage to underlying cause such as pneumonia or sepsis
Clinical Validation Requirements
- pO₂ <60 mmHg on room air
- SpO₂ <91%
- P/F ratio <300
Code-Specific Risks
- Misclassification as unspecified respiratory failure
- Failure to document specific hypoxemic criteria
Coding Notes
- Ensure documentation specifies acute hypoxemic respiratory failure with clinical validation.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Hypoxemia
R09.02Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hypoxemic Respiratory Failure to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code J96.01.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with coding guidelines., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Educate clinicians on documentation specificity, Implement documentation templates
Impact
Reimbursement: Potential underpayment due to unspecified coding., Compliance: Non-compliance with coding specificity requirements., Data Quality: Decreased accuracy in clinical data reporting.
Mitigation Strategy
Ensure documentation specifies hypoxia to use J96.01.
Impact
Risk of audits due to unspecified respiratory failure codes.
Mitigation Strategy
Ensure detailed documentation of clinical indicators and underlying causes.
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 Hypoxemic Respiratory Failure, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hypoxemic Respiratory Failure
Use these documentation templates to ensure complete and accurate documentation for Hypoxemic Respiratory Failure. These templates include all required elements for proper coding and billing.
Emergency Department Admission
Specialty: PulmonologyRequired Elements
- Reason for admission
- Clinical findings
- ABG results
- Imaging results
- Treatment plan
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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