Infections Due to Vascular Catheters:
The First Quarter 2019 Coding Clinic addressed several questions regarding infections due to vascular catheters. In summary the complication code should be assigned based on the location of the catheter tip rather than the function. ICD-10-CM classifies infections from a midline catheter (T82.7-) and a central venous catheter (T80.2) differently.
Midlines catheters are longer than a regular IV and are usually put into a vein in the arm. Sometimes a leg vein is used for infants. It can be used for 2 – 4 weeks which is longer than a regular IV, but not as long as a central line. Midlines are used for medications or fluids that do not irritate veins. A central venous catheter is put into a large vein and ends near the heart. Central venous catheters can be used for longer periods of time than a midline and are primarily used to give IV medications or IV fluids that can irritate veins and/or hemodialysis.
The entry for a midline infection can be referenced in the Index of Diseases as follows:
infection or inflammation T82.7
Central Venous Catheter: The Coding Clinic references 2019 ICD-10-CM Official Guideline C.1.d.5.b
(b) Sepsis due to a postprocedural infection
For infections following infusion, transfusion, therapeutic injection, or immunization, a code from subcategory T80.2, Infections following infusion, transfusion, and therapeutic injection, or code T88.0-, Infection following immunization, should be coded first, followed by the code for the specific infection. If the patient has severe sepsis, the appropriate code from subcategory R65.2 should also be assigned, with the additional code(s) for any acute organ dysfunction.
The table below summarizes the advice provided on pages 13 – 14.
|Patient is diagnosed with nosocomial gram-negative bacilli sepsis/blood stream infection, due to a midline catheter||T82.7xxA||Infection and inflammatory reaction due to other cardiac and vascular devices, implants and grafts, initial encounter|
|A41.59||Infection and inflammatory reaction due to other cardiac and vascular devices, implants and grafts, initial encounter|
|Patient with a midline catheter developed cellulitis of the left upper arm secondary to the catheter||T82.7xxA||Infection and inflammatory reaction due to other cardiac and vascular devices, implants and grafts, initial encounter|
|L03.114||Cellulitis of left upper limb,|
|Streptococcal Group B sepsis due to a hemodialysis central venous catheter||T80.211A||Bloodstream infection due to central venous catheter, initial encounter|
|A40.1||Sepsis due to streptococcus, group B|