ICD-10 Coding for Low Oxygen Saturation(R09.89, J96.01)
Complete ICD-10-CM coding and documentation guide for Low Oxygen Saturation. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Low Oxygen Saturation
Other specified symptoms and signs involving the circulatory and respiratory systems
Used for symptoms like respiratory desaturation when not meeting criteria for respiratory failure.
J96.0-J96.9Primary Range
Respiratory failure, not elsewhere classified
Covers acute and chronic respiratory failure, including hypoxic and hypercapnic types.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R09.89 | Other specified symptoms and signs involving the circulatory and respiratory systems | Use when hypoxia is documented without meeting respiratory failure criteria. |
|
| J96.01 | Acute respiratory failure with hypoxia | Use when criteria for acute hypoxic respiratory failure are met. |
|
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 low oxygen saturation
Essential facts and insights about Low Oxygen Saturation
Primary ICD-10-CM Codes for low oxygen saturation
Decision Criteria
clinical Criteria
- SpO2 between 85-89% without clinical deterioration.
Applicable To
- Respiratory desaturation
Excludes
- Respiratory failure (J96.-)
Clinical Validation Requirements
- SpO2 85-89% on room air
- No ABG confirmation
- No ventilatory support
Code-Specific Risks
- Incorrectly coding as J96.01 without meeting criteria.
Coding Notes
- Ensure documentation specifies absence of respiratory failure.
J96.01 - Acute respiratory failure with hypoxia
Use when criteria for acute hypoxic respiratory failure are met.
Applicable To
- Acute hypoxic respiratory failure
Excludes
- Chronic respiratory failure (J96.10-J96.92)
Clinical Validation Requirements
- SpO2 ≤90% with ABG PaO2 <60 mmHg
- Ventilatory support or clinical intervention
Coding Notes
Ensure ABG results or clinical intervention are documented.
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 Low Oxygen Saturation to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R09.89.
Impact
Clinical: Inaccurate clinical assessment, Regulatory: Non-compliance with documentation standards, Financial: Potential claim denials
Mitigation Strategy
Use specific SpO2 values, Document clinical interventions
Impact
Reimbursement: Incorrect coding can lead to claim rejections or lower reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Verify ABG results and clinical interventions before coding.
Impact
Incorrect coding of respiratory failure without proper documentation.
Mitigation Strategy
Regular audits and coder training on documentation requirements.
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 Low Oxygen Saturation, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Low Oxygen Saturation
Use these documentation templates to ensure complete and accurate documentation for Low Oxygen Saturation. These templates include all required elements for proper coding and billing.
Acute Hypoxic Respiratory Failure
Specialty: PulmonologyRequired Elements
- SpO2 levels
- ABG results
- Oxygen delivery method
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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