Home Health ICD-9/ICD-10 Alert

Question: When a patient has the diagnosis "urosepsis," should we code for it as a urinary tract infection (UTI) or a UTI with sepsis?

South Dakota Subscriber

Answer: In ICD-9, you have coding conventions to follow for "urosepsis." Report 599.0 (Urinary tract infection, site not specified) for this diagnosis. According to ICD-9 guidelines, "The term urosepsis is a nonspecific term. If that is the only term documented then only code 599.0 should be assigned based on the default for the term in the ICD-9-CM index, in addition to the code for the causal organism if known."

In the future: However, ICD-10 eliminates this term. When you look up the term "urosepsis" in the alphabetic index in your ICD-10 coding manual, you're directed to "code to condition." This means you must query the physician to determine the appropriate code assignment.

Action item: Work with physicians and clinicians to make certain they know "urosepsis" isn't a condition that can be coded in ICD-10. Try to help them to discontinue use of the term, unless they want to be bothered with queries. More specific documentation about this condition is necessary before you can assign an ICD-10 diagnosis code.