ICD-10-CM Specific Coding Guidelines - Methicillin-Resistant Staphylococcus Aureus (MRSA)

AMCI Medical Coding

14 Dec 202330:27

EducationalLearning

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TLDRThe video script discusses the coding guidelines for Mera (methan-resistant Staphylococcus aureus), a challenging bacterial infection to treat due to its resistance to penicillin and related medications. It outlines the use of combination codes for Mera infections and the general code B95.62 for cases without a specific combination code. The script also addresses the coding for Mera carriers without current infection using Z22.322. Two clinical scenarios are presented to demonstrate the application of these guidelines in coding for Mera-related conditions, emphasizing the importance of following the correct sequencing order for ICD10 CM codes.

Takeaways

😷 Merca (Methicillin-Resistant Staphylococcus Aureus) is a challenging bacterial infection resistant to penicillin and related medications.
📋 When coding for Merca, use a combination code for both the infection and the causal agent, or code the infection first followed by the general Merca code (B95.62) if there is no combination code available.
🔎 Combination codes for Merca include A49.02 for Merca-resistant Staphylococcus aureus infections.
🚫 Do not code resistance to penicillin alongside B95.62 as it is already implied in the name of the condition.
💼 Guidelines specify using Z22.322 for patients who are carriers of Merca but do not currently have an infection.
📝 Documentation and coding guidelines play a crucial role in accurately coding medical encounters.
💡 Understanding the sequencing order of codes is essential for proper medical coding.
📚 Referencing coding guidelines (e.g., C1 E1A) helps ensure accurate code selection and sequencing.
🩺 Clinical indicators and test results, such as positive Merca culture, guide code selection and sequencing.
🔍 Always prioritize specific codes over unspecified codes whenever possible for accurate medical coding.

Q & A

What does the acronym 'Mera' stand for?
-Mera stands for Methan-resistant Staphylococcus aureus, which is a form of bacteria that is difficult to treat due to its resistance to penicillin and related medications.
What is the significance of the term 'Mera' in the context of the script?
-In the context of the script, 'Mera' refers to a type of bacteria that is resistant to methicillin, making it challenging to treat with standard antibiotic medications. It is a critical consideration in coding for infections and the causal agent in medical documentation.
What is the correct ICD10 CM code for a patient with a methicillin-resistant Staphylococcus aureus infection?
-The correct ICD10 CM code for a patient with a Mera infection is A49.02, which is a combination code related to a staphylococcal infection.
How should one handle coding for a patient who is a carrier of Mera but does not have an active infection?
-For a patient who is a carrier of Mera without an active infection, the code Z22.322 should be used.
What is the recommended sequencing order for coding an infection caused by Mera?
-The recommended sequencing order for coding an infection caused by Mera is to first code the infection itself, followed by the general Mera code B95.62 if no combination code is available.
Why is it important to avoid coding resistance to penicillin with the B95.62 code?
-It is important to avoid coding resistance to penicillin with the B95.62 code because this code is specifically for Mera infections, which are inherently resistant to penicillin. Including resistance information with this code would be redundant as the name 'Mera' implies resistance.
What is the role of guidelines C1e1a and C1e1c in coding for Mera?
-Guidelines C1e1a and C1e1c provide specific instructions for coding Mera infections and carrier status. C1e1a guides the use of combination codes for the infection and causal agent, while C1e1c addresses coding for Mera carriers without current infection.
How does a physician confirm a suspicion of Mera infection?
-A physician can confirm a suspicion of Mera infection by ordering a culture and sensitivity test, which will identify the presence of Mera bacteria.
What is the significance of the term 'sequencing order' in the context of medical coding?
-Sequencing order in medical coding refers to the specific order in which conditions and their causes are listed in a patient's medical record. This order is important for accurate data recording and reimbursement purposes.
What is the correct ICD10 CM code for a patient with a non-healing abscess on the leg caused by Mera?
-The correct ICD10 CM code for a patient with a non-healing abscess on the leg caused by Mera is L041, which is a code for cutaneous abscess of the limb, followed by the code for the specific infection, which in this case is A49.02 for Mera.
How does a patient's positive Mera test impact the coding process?
-A patient's positive Mera test impacts the coding process by requiring the use of specific codes that reflect the infection's resistance to certain antibiotics. It also necessitates following specific guidelines for sequencing the infection and causal agent codes in the patient's medical record.

Outlines

00:00

🎵 Understanding Mera and Coding Guidelines

This paragraph introduces Mera, an acronym for Methan-resistant Staphylococcus aureus, a challenging form of bacteria resistant to penicillin and related medications. It emphasizes the importance of following specific coding guidelines (C1 e1a) for Mera, which involve using combination codes for the infection and causal agent, and the correct sequencing of codes. The paragraph also clarifies that resistance to penicillin should not be coded separately as it is implied in the name Mera.

05:01

📌 Coding Scenario: Mera Infection and Carrier Status

The paragraph presents a coding scenario involving a patient with a Mera infection and explains the use of specific ICD-10 CM codes. It details the process of selecting the appropriate codes based on the patient's condition and the guidelines provided. The scenario also addresses the coding for a Mera carrier without current infection, using the code Z22.322. The paragraph concludes with a quiz to test the understanding of the coding process.

10:05

🔍 Code Analysis and Sequencing for Mera Cases

This section delves into the analysis of ICD-10 CM codes for Mera infections, emphasizing the proper sequencing and the use of combination codes. It clarifies the difference between Mera (Methicillin-resistant Staphylococcus aureus) and MSSA (Methicillin-susceptible Staphylococcus aureus) and their respective codes. The paragraph also discusses the elimination of incorrect codes based on the guidelines and the correct sequencing order for conditions and causal agents.

15:07

🏥 Clinical Scenario: Sepsis and Mera Pneumonia

The paragraph describes a clinical scenario of a 70-year-old male patient presenting with symptoms that lead to a diagnosis of acute renal failure due to severe sepsis from Mera pneumonia. It outlines the process of identifying key symptoms, differentiating between primary and secondary conditions, and applying the correct ICD-10 CM codes based on the patient's presentation and laboratory results. The paragraph also highlights the importance of following guidelines for coding sepsis and organ dysfunction.

20:49

📚 Correct Coding Sequence for Sepsis and Organ Dysfunction

This section focuses on the correct coding sequence for systemic infections, sepsis, and organ dysfunction, as per the guidelines. It clarifies the sequence of coding for sepsis due to a specific organism, such as Mera, and the conditions that follow. The paragraph provides a detailed explanation of how to apply the guidelines to the given clinical scenario, resulting in the correct coding sequence for the patient's condition.

25:51

📝 Recap of Mera, MSSA, and Coding Guidelines

The final paragraph recaps the key points discussed in the video script, including the distinction between Mera and MSSA, the coding guidelines for Mera infections and carrier status, and the importance of following the correct sequencing order for coding. It concludes with a reminder of the importance of understanding and applying these guidelines for accurate medical coding.

Mindmap

Keywords

💡Mera

Mera stands for Methicillin-resistant Staphylococcus aureus (MRSA), which is a type of bacteria that is resistant to certain antibiotics, including penicillin. In the context of the video, Mera represents a challenging infection to treat due to its resistance to common medications. The video discusses coding guidelines for Mera, emphasizing the importance of using the correct combination code when documenting such infections in medical records.

💡ICD-10-CM codes

ICD-10-CM codes are the International Classification of Diseases, 10th Revision, Clinical Modification codes used in the United States for documenting diagnoses and procedures for medical billing and statistical purposes. The video focuses on the correct application of these codes, particularly for Mera infections and related conditions, to ensure accurate medical record-keeping and reimbursement.

💡Combination codes

Combination codes in the ICD-10-CM system allow for the documentation of both the infection and the causal agent, such as the specific bacteria causing the infection. These codes are crucial for healthcare providers to understand the full context of a patient's condition and to track the prevalence of certain infections, like Mera.

💡Penicillin resistance

Penicillin resistance refers to the ability of certain bacteria to withstand the effects of penicillin antibiotics, which are a common class of antimicrobial drugs. Mera is noted for its resistance to penicillin and related antibiotics, making infections caused by this bacteria more difficult to treat. This concept is important in the video as it influences the selection of appropriate ICD-10-CM codes for documentation.

💡Carrier

A carrier is an individual who harbors a pathogen, such as Mera, without showing symptoms of the disease. This is significant in the context of the video because there are specific ICD-10-CM codes for individuals who are carriers of certain diseases, even if they are not currently infected or showing symptoms.

💡Coding guidelines

Coding guidelines are the rules and recommendations provided for the use of ICD-10-CM codes to ensure consistency and accuracy in medical record-keeping. The video emphasizes the importance of following these guidelines when coding for conditions like Mera infections to facilitate proper documentation and billing.

💡Non-healing abscess

A non-healing abscess is a type of wound that does not improve or close as expected, often due to underlying conditions such as bacterial infections like Mera. This term is significant in the video as it describes a symptom that may be indicative of a Mera infection, guiding healthcare providers in their diagnostic and coding processes.

💡Sepsis

Sepsis is a life-threatening condition caused by the body's response to an infection, leading to organ dysfunction and potentially multiple organ failure. In the video, sepsis is mentioned as a severe complication arising from a Mera infection, emphasizing the seriousness of such cases and the need for accurate coding to reflect the complexity of the patient's condition.

💡Acute renal failure

Acute renal failure, also known as acute kidney injury, is a sudden loss of kidney function that occurs over hours to days. In the context of the video, it is a serious complication resulting from sepsis caused by a Mera infection, which necessitates specific ICD-10-CM codes to capture the severity and cause of the kidney failure.

💡Pneumonia

Pneumonia is an infection of the lungs that can be caused by various pathogens, including bacteria like Mera. In the video, pneumonia is mentioned as a potential complication arising from a Mera infection, which is significant for coding purposes as it requires specific ICD-10-CM codes to describe the type and severity of the lung infection.

Highlights

Mera is an acronym for methan resistant staphylococcus aureus, a difficult form of bacteria to treat.

Mera is resistant to penicillin and other medications in that family.

When coding for Mera, use a combination code for the infection and the causal agent if available.

For Mera infections, the combination code A49.02 is used for a staphylococcus infection.

If no combination code exists for Mera, code the infection first followed by the general Mera code B95.62.

Do not code resistance to penicillin with B95.62 as it is understood to be part of the Mera infection.

For a Mera carrier with no current infection, use the code Z22.322.

The case study involves a 55-year-old female with a non-healing abscess on her leg suspected to be caused by Mera.

A culture and sensitivity test confirmed the presence of Mera in the patient.

When coding for the encounter, focus on the key elements: non-healing abscess on leg, warm to touch, and positive for Mera.

The correct ICD10 CM code for the encounter is L01.0, which is for cutaneous abscess of the leg.

The subcategory code L241 indicates a cutaneous abscess of limb, unspecified.

For Mera as the cause of disease classified elsewhere, the code B95.62 is used.

The scenario of a 70-year-old male with an injured toe leading to acute renal failure due to severe sepsis from Mera is discussed.

The patient's condition deteriorated rapidly with symptoms such as shortness of breath, shaking chills, and purulent drainage from the toe.

The correct coding sequence for the case involves first coding the underlying systemic infection (A41.02), followed by severe sepsis (R65.2), and then organ dysfunction (N17).

A41.51 is the code for sepsis due to unspecified organism, and it should be sequenced first when coding for sepsis.

For a patient with Mera pneumonia, the code J1, 15212 with R65.21 is used to indicate pneumonia due to staphylococcus.

Methicillin-susceptible staphylococcus aureus (MSSA) is susceptible to penicillin and is coded as B95.61.

For an MSSA carrier without the bacterial infection, the code Z22.321 is used.

Transcripts

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MeraInfections ICD10Coding MedicalBilling AntibioticResistance HealthcareCompliance ClinicalGuidelines InfectionManagement MedicinalTreatment HealthcareEducation BacterialDiseases