Catheter-associated urinary tract infection (CAUTI) is the most common infection that patients acquire within healthcare facilities. According to a study published in BMC Health Services Research in May 2017, urinary tract infections in general account for up to 36 percent of the infections that are acquired within healthcare facilities, and around 80 percent are associated with catheters. As a result, many small clinics — including family physicians offices and urology specialists — regularly see patients who have contracted a CAUTI. Read on to learn more about coding procedures for this condition.
ICD-10-CM Diagnosis Codes for CAUTI
The non-billable, non-specific code for infection and inflammatory reaction due to urinary catheter is T83.51. The generalized version of the billable code is T83.51XA, where “X” is a number that indicates whether it is patient’s first, second, third, or later encounter. For instance, T83.511A is the billable code for the first encounter with a patient who has an infection and inflammatory reaction due to an indwelling urinary catheter.
It is important to note that ICD-10-CM T83.511A is one of the newly added ICD-10-CM codes for 2017. It became effective on October 1, 2016. Although there is no directly equivalent ICD-9-CM code, the most closely associated predecessor was 996.64 – Infection and inflammatory reaction due to an indwelling urinary catheter.
T83.511 as a Complication of Another Condition
The parent code of T83.511A is T83.511. Often, it is listed as a complication from another condition. In these cases, the code T83.9 is coded alongside T83.511. This is true when CAUTI is a complication of the following conditions:
a – Implant of a urethral catheter
b – Graft (bypass) patch of a urinary organ
c – Genourinary device or implant for the urinary system
Other Possible Coding Options
Another way to code CAUTI is as an infection due to a device implant, or graft. In both opportunistic infection cases and cases with exudation, the code T85.79 would be coded alongside T83.511. If the patient experiences sepsis as a result of the CAUTI, that same code (T85.79) would also be relevant.
Clearly, coding CAUTIs in ICD-10-CM can be a major hassle. Not only was the new code introduced relatively recently, but there are a wide range of associated codes that may need to be included in order to ensure proper reimbursement. Given the prevalence of CAUTIs today, getting it right is essential. Therefore, you may want to consider outsourcing your medical coding to the experts at AnnexMed, who are well-equipped to handle the challenge. Contact us today for more information about our services!