ICD-10 Coding for Respiratory Distress Syndrome(J80, U07.1)
Complete ICD-10-CM coding and documentation guide for Respiratory Distress Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Respiratory Distress Syndrome
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| J80 | Acute respiratory distress syndrome | Use when all Berlin criteria for ARDS are met. |
|
| U07.1 | COVID-19 | Use with J80 when ARDS is due to COVID-19. |
|
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 respiratory distress syndrome
Essential facts and insights about Respiratory Distress Syndrome
Primary ICD-10-CM Codes for respiratory distress syndrome
Decision Criteria
clinical Criteria
- All Berlin criteria must be documented.
coding Criteria
- Do not use if criteria are not met.
Applicable To
- ARDS
Excludes
- Neonatal respiratory distress syndrome (P22.0)
Clinical Validation Requirements
- Acute onset within 7 days
- Bilateral infiltrates on imaging
- PaO₂/FiO₂ ≤300 mmHg on PEEP ≥5 cmH₂O
- Exclusion of cardiac failure
Code-Specific Risks
- Misclassification if Berlin criteria are not fully documented.
Coding Notes
- Ensure documentation specifies ARDS criteria and excludes cardiac causes.
U07.1 - COVID-19
Use with J80 when ARDS is due to COVID-19.
Applicable To
- COVID-19 infection
Clinical Validation Requirements
- Confirmed COVID-19 diagnosis
Coding Notes
Ensure COVID-19 is confirmed and documented.
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 Respiratory Distress Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code J80.
Impact
Clinical: Lack of clarity on treatment approach., Regulatory: Potential audit issues., Financial: Incorrect DRG assignment.
Mitigation Strategy
Always document the underlying cause of ARDS.
Impact
Reimbursement: Incorrect DRG assignment leading to reimbursement issues., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure all Berlin criteria are documented for ARDS.
Impact
Failure to document all Berlin criteria can lead to incorrect coding.
Mitigation Strategy
Implement checklist for ARDS criteria in documentation.
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 Respiratory Distress Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Respiratory Distress Syndrome
Use these documentation templates to ensure complete and accurate documentation for Respiratory Distress Syndrome. These templates include all required elements for proper coding and billing.
ICU Admission for ARDS
Specialty: PulmonologyRequired Elements
- Diagnosis of ARDS with Berlin criteria
- Etiology of ARDS
- Management plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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