The ICD-10-CM Official Guidelines for Coding and Reporting provide instruction on the proper sequencing of acute respiratory failure. Patients with acute respiratory failure require repeated assessments and close observation. It can arise from an abnormality in any of the components of the respiratory, central nervous, or peripheral nervous systems and the respiratory and chest wall muscles. It is usually the final pathway of a disease process or a combination of different processes. Always due to an underlying condition, respiratory failure is a life-threatening ailment. Although there are several reasons for claim denials, including lack of medical necessity, authorizations, and inputting and coding issues (eg, not documented by the physician, improper sequencing), facilities have seen a specific increase in denials based on what the payer deems as “lack of clinical indicators to support the condition.” Acute respiratory failure is one of several “high-risk” diagnoses that are frequently denied-even if indicators are present.Īcute respiratory failure is defined as respiratory dysfunction resulting in hypoxemia (low arterial oxygen levels), hypercapnia (elevated levels of carbon dioxide gas), or a combination of the two. Audit Alley: How to Expel Acute Respiratory Failure Denialsīy now, most facilities have experienced many claim denials regarding the assignment of code J96.XX for acute respiratory failure.

Icd 10 code for hypoxia