UTI is URINARY TRACT INFECTION (UTI),

 ICD 9 – 599.0 Urinary tract infection, site not specified

More specific ICD-10 choices include:

ICD 10 CODE

O23.3 Infections of other parts of urinary tract in pregnancy
O23.4 Unspecified infection of urinary tract in pregnancy
O86.2 Urinary tract infection following delivery
R30.0 – Dysuria
R30.9 – Painful micturition, unspecified
N39.0 – Urinary tract infection, site not specified
N30.00 – Acute cystitis w/o hematuria
N30.01 – Acute cystitis with hematuria
N30.10 – Interstitial cystitis (chronic) without hematuria
N30.11 – Interstitial cystitis (chronic) with hematuria
N31.40 – Irradiation cystitis without hematuria
N31.41 – Irradiation cystitis with hematuria
N15.9 – Renal tubule-interstitial disease,unspecified

Site: Bladder Urethra or ureter Kidney

Type:

Pyelonephritis (obstructive, reflux uropathy, drug or heavy metal induced) Cystitis (obstructive, interstitial, trigonitis, irradiation, etc.)


Acuity:

Acute, chronic or acute on chronic

Causal organism:
 E. Coli, Enterococcus Klebsiella pneumoniae Pseudomonas, Candida Gonococcal, Chlamydial MRSA, MSSA, other, etc.

Complication (due to):

Indwelling Foley catheter Cystostomy or nephrostomy tube Suprapubic catheter  Urethral stents or other devices Postoperative / postprocedural, etc.

Associated conditions:

Hydronephrosis (due to ureteral stricture, calculus obstruction, reflux nephropathy, hydroureter, etc.) Urethritis Hematuria

A beneficiary has clinical signs and symptoms indicative of a possible urinary tract infection (UTI). Acute lower UTI may present with urgency, frequency, nocturia, dysuria, discharge or incontinence. These findings might also be noted in upper UTI with additional systemic symptoms (for example, fever, chills, lethargy); or pain in the costovertebral, abdominal, or pelvic areas. Signs and symptoms might overlap considerably with other inflammatory conditions of the genitourinary tract (for example, prostatitis, urethritis, vaginitis, or cervicitis). Elderly or immunocompromised beneficiaries or those with neurologic disorders might present atypically (for example, general debility, acute mental status changes, declining functional status).

The HIV-1 core antigen (p24) test detects circulating viral antigen which may be found prior to the development of antibodies and may also be present in later stages of illness in the form of recurrent or persistent antigenemia. Its prognostic utility in HIV infection has been diminished as a result of development of sensitive viral RNA assays, and its primary use today is as a routine screening tool in potential blood donors.

Code Description

T58.02XS Toxic effect of carbon monoxide from motor vehicle exhaust, intentional self-harm, sequela

T58.03XS Toxic effect of carbon monoxide from motor vehicle exhaust, assault, sequela

T58.04XS Toxic effect of carbon monoxide from motor vehicle exhaust, undetermined, sequela

T58.11XS Toxic effect of carbon monoxide from utility gas, accidental (unintentional), sequela

T58.12XS Toxic effect of carbon monoxide from utility gas, intentional self-harm, sequela

T58.13XS Toxic effect of carbon monoxide from utility gas, assault, sequela

T58.14XS Toxic effect of carbon monoxide from utility gas, undetermined, sequela

T58.2X1S Toxic effect of carbon monoxide from incomplete combustion of other domestic fuels, accidental (unintentional), sequela

T58.2X2S Toxic effect of carbon monoxide from incomplete combustion of other domestic fuels, intentional self-harm, sequela

T58.2X3S Toxic effect of carbon monoxide from incomplete combustion of other domestic fuels, assault, sequela

T58.2X4S Toxic effect of carbon monoxide from incomplete combustion of other domestic fuels, undetermined, sequela

T58.8X1S Toxic effect of carbon monoxide from other source, accidental (unintentional), sequela

T58.8X2S Toxic effect of carbon monoxide from other source, intentional self-harm, sequela

T58.8X3S Toxic effect of carbon monoxide from other source, assault, sequela

T58.8X4S Toxic effect of carbon monoxide from other source, undetermined, sequela

T58.91XS Toxic effect of carbon monoxide from unspecified source, accidental (unintentional), sequela

T58.92XS Toxic effect of carbon monoxide from unspecified source, intentional self-harm, sequela

T58.93XS Toxic effect of carbon monoxide from unspecified source, assault, sequela

T58.94XS Toxic effect of carbon monoxide from unspecified source, undetermined, sequela

T59.0X1S Toxic effect of nitrogen oxides, accidental (unintentional), sequela

T59.0X2S Toxic effect of nitrogen oxides, intentional self-harm, sequela

T59.0X3S Toxic effect of nitrogen oxides, assault, sequela

T59.0X4S Toxic effect of nitrogen oxides, undetermined, sequela

T59.1X1S Toxic effect of sulfur dioxide, accidental (unintentional), sequela

T59.1X2S Toxic effect of sulfur dioxide, intentional self-harm, sequela

T59.1X3S Toxic effect of sulfur dioxide, assault, sequela

T58.02XS Toxic effect of carbon monoxide from motor vehicle exhaust, intentional self-harm, sequela

T58.03XS Toxic effect of carbon monoxide from motor vehicle exhaust, assault, sequela

T58.04XS Toxic effect of carbon monoxide from motor vehicle exhaust, undetermined, sequela

T58.11XS Toxic effect of carbon monoxide from utility gas, accidental (unintentional), sequela

T58.12XS Toxic effect of carbon monoxide from utility gas, intentional self-harm, sequela

T58.13XS Toxic effect of carbon monoxide from utility gas, assault, sequela

T58.14XS Toxic effect of carbon monoxide from utility gas, undetermined, sequela

T58.2X1S Toxic effect of carbon monoxide from incomplete combustion of other domestic fuels, accidental (unintentional), sequela

T58.2X2S Toxic effect of carbon monoxide from incomplete combustion of other domestic fuels, intentional self-harm, sequela

T58.2X3S Toxic effect of carbon monoxide from incomplete combustion of other domestic fuels, assault, sequela

T58.2X4S Toxic effect of carbon monoxide from incomplete combustion of other domestic fuels, undetermined, sequela

T58.8X1S Toxic effect of carbon monoxide from other source, accidental (unintentional), sequela

T58.8X2S Toxic effect of carbon monoxide from other source, intentional self-harm, sequela

T58.8X3S Toxic effect of carbon monoxide from other source, assault, sequela

T58.8X4S Toxic effect of carbon monoxide from other source, undetermined, sequela

T58.91XS Toxic effect of carbon monoxide from unspecified source, accidental (unintentional),  sequela

T58.92XS Toxic effect of carbon monoxide from unspecified source, intentional self-harm, sequela

T58.93XS Toxic effect of carbon monoxide from unspecified source, assault, sequela

T58.94XS Toxic effect of carbon monoxide from unspecified source, undetermined, sequela

T59.0X1S Toxic effect of nitrogen oxides, accidental (unintentional), sequela

T59.0X2S Toxic effect of nitrogen oxides, intentional self-harm, sequela

T59.0X3S Toxic effect of nitrogen oxides, assault, sequela

T59.0X4S Toxic effect of nitrogen oxides, undetermined, sequela

T59.1X1S Toxic effect of sulfur dioxide, accidental (unintentional), sequela

T59.1X2S Toxic effect of sulfur dioxide, intentional self-harm, sequela

T59.1X3S Toxic effect of sulfur dioxide, assault, sequela


Limitations

Because of significant specimen to specimen collagen crosslink physiologic variability (15-20%), current recommendations for appropriate utilization include: one or two base-line assays from specified urine collections on separate days; followed by a repeat assay about 3 months after

Coding UTI to Sepsis in ICD-9-CM and ICD-10-CM 

Multiple factors contribute to urinary tract infections (UTIs); common causes are aging and medications, especially in combination.

Aging is associated with changes in kidney structure and muscle strength. The kidneys lose their ability to filter waste from the blood. Muscles in the ureters, bladder, and urethra weaken. These changes lead to increased urinary retention within the bladder, creating the environment for bacterial overgrowth and infection.

Many medications cause urinary retention. When combined with the normal decline in filtering efficiency  associated with aging, the geriatric population is at increased risk for UTIs.

Other factors that affect the function of the urinary tract and increase the risk of outflow problems and infections include congenital abnormalities, illness, and injury.

Women are more prone to UTIs than adult men. Infections can occur anywhere along the urinary tract, and they may be localized or disseminated.


Diagnosing and Treating UTIs

Diagnosing UTIs is done through a combination of clinical history, examination, and laboratory tests. Infants and the elderly may present with no symptoms at all. Other patients might complain of fever, chills, anorexia, nausea, vomiting, diarrhea, pain in the abdomen or back, dysuria, hematuria, incontinence, decreased urine output or the inability to urinate, and/or altered mental status/confusion. Physical examination findings can include pain anywhere in the abdomen, pelvis, or lower back.

Laboratory evaluation starts with the urinalysis. The test looks at the specific gravity, pH, presence of leukocytes, nitrates, blood, glucose, and protein. In addition, microscopic studies will quantify the presence of white and red blood cells, bacteria, or other organisms such as yeast and trichomonads.

Urine can be plated and followed for bacterial growth and bacterial sensitivities (culture and sensitivity test). An ultrasound or fluoroscopy of the urinary tract is used to measure dynamic outflow and tract function. Diagnostic xrays, CT scans, and MRIs are used for a static analysis of anatomy and potential obstruction. Cystograms involve the use of a small camera inside a tube inserted through the urethra for a real-time visual inspection of the bladder.

UTIs can be treated effectively with antibacterial medications. However, UTIs can lead to sepsis especially in elderly patients or patients with compromised immune systems. Patients diagnosed with sepsis require immediate medical attention and are typically treated with intravenous fluids and antibiotics.

The extent and severity of the infection is based on the diagnostic criteria mentioned above. Common UTIs include:

Urethritis: an infection within the urethra commonly associated with sexually transmitted diseases.
Cystitis: an infection localized to the bladder. The most common pathogen is E. coli bacteria.
Pyelonephritis: the progression of the infection from the bladder to one or both kidneys.
Urosepsis: a nonspecific term indicating an infection anywhere within the urinary tract. In ICD-9-CM, based on the default for this term in the alphabetic index, urosepsis is assigned code 599.0, Urinary tract infection, site not specified. In ICD-10-CM, this term has no default code in the alphabetic index and will require a
physician query for clarification and specification.

ICD-9-CM ICD-10-CM 

595.9, Cystitis, unspecified        N30.90, Cystitis, unspecified without hematuria

ICD 9 CODE 598.9 Urethral stricture, unspeci ed can be replaced by

N35.8 Other urethral stricture, unspeci ed
N35.12 Postinfective urethral stricture, not elsewhere classi ed, female
N35.119 Postinfective urethral stricture, not elsewhere classi ed, male, unspeci ed
N35.114 Postinfective anterior urethral stricture, not elsewhere classi ed
N35.113 Postinfective membranous urethral stricture, not elsewhere classi ed
N35.112 Postinfective bulbous urethral stricture, not elsewhere classi ed
N35.111 Postinfective urethral stricture, not elsewhere classi ed, male, meatal
N35.028 Other post-traumatic urethral stricture, female
N35.021 Urethral stricture due to childbirth
N35.014 Post-traumatic urethral stricture, male, unspeci ed
N35.013 Post-traumatic anterior urethral stricture
N35.012 Post-traumatic membranous urethral stricture
N35.011 Post-traumatic bulbous urethral stricture
N35.010 Post-traumatic urethral stricture, male, meatal
N35.9 Urethral stricture, unspeci ed

ICD for UTI

UTI is URINARY TRACT INFECTION (UTI),  ICD 9 – 599.0

More specific ICD-10 choices include:
R30.0 – Dysuria
R30.9 – Painful micturition, unspecified
N39.0 – Urinary tract infection, site not specified
N30.00 – Acute cystitis w/o hematuria
N30.01 – Acute cystitis with hematuria
N30.10 – Interstitial cystitis (chronic) without hematuria
N30.11 – Interstitial cystitis (chronic) with hematuria
N31.40 – Irradiation cystitis without hematuria
N31.41 – Irradiation cystitis with hematuria
N15.9 – Renal tubule-interstitial disease,unspecified



Icd 9 code for back pain

724.5 is to be used for Back Pain
724.5 – Backache, unspecified Vertebrogenic (pain) syndrome NOS  Toggle Dictionary Definitions
724 Excludes: collapsed vertebra (code to cause, e.g., osteoporosis, 733.00-733.09), conditions due to: intervertebral disc disorders (722.0-722.9), spondylosis (721.0-721.9)
720-724 Excludes: curvature of spine (737.0-737.9), osteochondrosis of spine (juvenile) (732.0), adult (732.8)
710-739  Use additional external cause code, if applicable, to identify the cause of the musculoskeletal condition
724 Other and unspecified disorders of back
724.00 – 724.09     724.0 Spinal stenosis, other than cervical
724.1     Pain in thoracic spine
724.2     Lumbago
724.3     Sciatica Excludes
724.4     Lumbosacral neuritis NOS Non-specific
724.5     Backache NOS Non-specific
724.6     Disorders of sacrum
724.70 – 724.79     724.7 Disorders of coccyx
724.8     Other back symptoms
724.9     Back disorder NOS



ICD 10 CODE

M54.5 – Low back pain



ICD 9 CODE AND ICD 10  CODE

Contusion 922.31     Contusion of lower back and pelvis, initial encounter S30.0XXA

Pain lower back 724.2    Low back pain M54.5

                                      Causes
and considerable symptoms of back pain

Back pain is a very common cause for
often visits to the doctor. Back pain may be uncomfortable and painful, but it
is not typically serious. It can affect people of all ages and it is more usual
along with adults aged between 35 to 55 years. Professional experts say that
back pain is related with the way bones, ligaments and muscles in backs work
jointly. Pain in the lower back may be associated to the discs, lower back
muscles and even more. However, pain in the upper back may be due to disarrays
of tumors in the chest, aorta and spine inflammation. When you have back pain and low back pain, you have
to recognize the causes or reasons of that pain first. A risk factor is
something which improves the chance of developing a disease or condition. Some
factors are linked to a great risk of developing low back pain such as
stressful job, smoking, pregnancy, obesity and even more.

Results
of poor posture
Complex structure of tendons, ligaments,
disks, muscles and bones are composed at the human back. Issues with some of
these components may show the way to back pain. Back pain can also be the
outcome of some poor posture or everyday activity. It is important that you
have to know about the good posture of sitting, pushing, lifting, coughing and
a lot for longer periods. Sometime long driving sessions devoid of break can
also lead to severe back pain. Low back pain can be caused by a lot of troubles
with any sections of the complex, nerves, discs or spinal muscles.

When you notice any severe back pain,
you have to seek the help of professional doctor instantly. A problem or
irritation with any of these back structures can cause lower back pain that
radiates into another part of the body. Many back pain and low back pain problems also cause an issue on back muscle
spasms that can give disability and severe pain. You should not leave any mild
pain at the back as a simple thing. You will not know about the serious of that
pain.

Know
the symptom and get an analysis

Identifying the signs of back pain and
obtaining a treatment is considered to be the first step for efficient pain
relief. Young adults are more highly to experience back pain from soft tissue
or from a back muscle. Older adults are likely to suffer from back pain
associated to joint degeneration. The reasons and symptoms of back pain and
lower back pain may differ as per the physical activity, age and other factors.
It is important that you have to consider each body sign as a crucial thing to
get rid of serious troubles. If you get the back pain accompanied with other
symptoms like chills, fever, significant leg weakness and much more, you have
to seek immediate treatment without any delay. Professional experts will
examine your body and analyze the seriousness of your back pain. After that,
they will take appropriate steps to treat your back pain in an efficient
manner. 







Scenario 1: Urinary Obstruction, Transurethral Resection of the Prostate 


History of Present Illness


80 year old male with history of BPH failing outpatient therapy with alpha blockers and 5-alpha-reductase inhibitors. Admitted today with chief complaint of lower abdominal pain, inability to urinate over the last 24 hours. Diagnosis confirmed of acute renal failure due to caused by post renal urinary obstruction. The urinary obstruction is the result of the patient’s benign prostatic hypertrophy obstructing bladder outlet. Patient now admitted for resection of the prostrate as definitive treatment. 


Past Medical History


o Benign Prostatic hypertrophy
o Hypertension, controlled with medication
Pertinent Physical Exam


o Vitals: Pulse 88, BP: 138/88, RR-18-22, O2 sat @ 96%, Temp 37 C.
o Neuro: AAOx3 PERAL Neuro wears glasses, hard of hearing.
o Pulmonary; bilateral breath sounds decreased at the bases RR 18 to 22, O2saut 96%.
o Cardiac; Heart rate strong and regular positive peripheral pulses.
o Abdomen: Soft, non-tender, no guarding. Bladder visibly distended, with mild tenderness on palpation.
o Rectal exam demonstrates enlarged palpable prostate. 
Assessment and Plan


Admitted for transurethral resection of the prostate.


Operative Notes


After operative consent, the patient was brought to the operating room and placed on the table in the supine position. With spinal anesthesia induced, the patient was converted to the dorsolithotomy position. The genital area was prepped and draped in the usual and sterile fashion. A 26 French continuous flow resectoscope sheath was inserted per urethra into the bladder with the obturator in place. The obturator was removed and the resectoscope was seated within its sheath.



The bladder was visualized. The ureteral orifices were identified. The resectoscope was pulled to the distal portion of the verumontanum and turned to the 12 o’clock position, and resection of the posterior lobe was begun. Resection of the posterior lobe was carried circumferentially around the glans, channeling a large channel. Hemostasis was obtained by means of electrocoagulation. A 22 French, 3- way, 30-cc Foley catheter was inserted per urethra into the bladder with ease. It was irrigated until clear. It was placed on light traction




599.0 Urinary tract infection, site not specified


ICD-10-CM Codes


N39.0 Urinary tract infection, site not specified


** Use additional code (B95-B97)to identify infectious agent
** There are more specific code choice selections available in


ICD-10-CM. These include:


N30.00 Acute cystitis without hematuria


N30.01 Acute cystitis with hematuria


N30.10 Interstitial cystitis (chronic) without hematuria


N30.11 Interstitial cystitis (chronic) with hematuria


N30.20 Other chronic cystitis without hematuria


N30.21 Other chronic cystitis with hematuria


N30.30 Trigonitis without hematuria


N30.31 Trigonitis with hematuria


N30.40 Irradiation cystitis without hematuria


N30.41 Irradiation cystitis with hematuria


N30.80 Other cystitis without hematuria


N30.81 Other cystitis with hematuria


ICD-10-CM Codes


N20.0 Calculus of kidney


N20.9 Urinary calculus; unspecified


N20.2 Calculus of kidney and ureter


600.01 Hypertrophy (benign) of prostate with urinary obstruction and other lower urinary tract symptoms (LUTS) lower urinary tract symptoms (LUTS)


ICD-10-CM Codes


Two codes are required in ICD-10-CM:


N40.1 Enlarged prostate with lower urinary tract symptoms (LUTS); AND

N13.8 Other obstructive and reflux uropathy