Name that Pneumonia
This type of PNA describes where the infection was acquired, not the type of PNA. (name at least 2)
What are CAP, HAP, HCAP
pt with pmhx HTN, Afib, CAD s/p CABG x 1. Abx Levaquin. Query or No query - must verbalize your rationale
What is no? No risk factors
This finding on a CXR or Chest CT commonly support the diagnosis of pneumonia.
What are infiltrates?
Add this documentation characteristic to PNA improves representation of patient acuity.
What is pneumonia specificity?
Coding professionals cannot assign pneumonia due to MRSA based solely on this finding.
What is a positive sputum culture (or laboratory result) without provider documentation linking it to pneumonia?
This pneumonia must be specifically documented and cannot be assumed from dysphagia or a failed swallow study.
What is aspiration pneumonia?
pt with "cavitary pneumonia" on vancomycin - Query or no Query - remember to give rationale for response
What is query for MRSA PNA? Based on risk factors and treatment
Elevated WBC and this laboratory marker may support pneumonia.
What is procalcitonin?
Unspecified pneumonia generally groups to this DRG family.
What is Simple Pneumonia and Pleurisy?
A patient with dysphagia after a CVA is treated with Zosyn for a right lower lobe infiltrate. The provider documents only "pneumonia." CDI should seek clarification for what diagnosis.
What is aspiration pneumonia?
Documentation of this pneumonia type can be supported by risk factors and antibiotic coverage even without a positive sputum culture.
What is gram-negative pneumonia?
pt with pmhx CHF, CKD, DM. Abx Levaquin -Query or no query - remember to give rationale for response
What is query for gram negative PNA? Based on risk factors and abx treatment
Prior hospitalization with IV antibiotics within this timeframe is a risk factor for gram-negative pneumonia.
What are the previous 90 days?
Aspiration pneumonia, gram-negative pneumonia, and Pseudomonas pneumonia generally group to this DRG family.
What are Respiratory Infections and Inflammations DRGs?
MRSA is classified as this type of bacteria
Pseudomonas, aspiration, MRSA, and gram-negative pneumonia are classified as this.
What is complex pneumonia?
pt with pmhx CVA and aphasia, SLP workup positive for aspiration, on Rocephin and Zithromax transitioned to augmentin - Query or no query - remember to provide rationale for response
What is query for aspiration PNA based on risk factors, clinical indicators and treatment.
This prior microbiology history increases suspicion for gram-negative pneumonia.
What is prior Pseudomonas colonization or infection?
One major reason CDI focuses on pneumonia specificity is to reduce these.
What are payer denials?
True or false that all gram negative organisms move to Complex PNA DRGs
What is false?
If documented at discharge as probable, likely, or suspected, this can still be coded.
What is a specified pneumonia diagnosis?
pt with pmhx kidney transplant on immunosuppressant, on cefepime and vancomycin, MRSA swab returns negative and vanc is d/c'd, transitioned to PO Levaquin to complete 5 day course at discharge. Query or no query - rationale?
What is query for gram negative PNA? based on risk factors, treatment.
Bronchiectasis, cystic fibrosis, and major airway obstruction belong to this category of risk factors.
What are structural lung diseases?
his hospital metric is influenced by accurate pneumonia documentation.
What is Case Mix Index (CMI)?
when a respiratory culture yields an organism that is not listed in the encoder, confirmed by the provider as the type of PNA, it goes to this type.
what is Pneumonia due to other specified bacteria (J158) - will also accept "complex PNA DRG"?