2025 ICD-10-CM code J95.1
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Respiratory System Disorders - Intraoperative and postprocedural complications and disorders of respiratory system, not elsewhere classified Chapter 10: Diseases of the respiratory system Feed
Acute pulmonary insufficiency following thoracic surgery.
Medical necessity is established when the acute pulmonary insufficiency is a direct consequence of the thoracic surgical procedure. The severity of the respiratory compromise and the need for interventions like mechanical ventilation or supplemental oxygen support the medical necessity of the codes applied.
The clinical responsibility lies with the surgeon and the anesthesiologist involved in the thoracic surgery, as well as the post-operative care team including pulmonologists and intensive care specialists.Monitoring vital signs, respiratory support, and managing complications are key aspects of care.
- Chapter 10: Diseases of the respiratory system
- J95-J95.89: Intraoperative and postprocedural complications and disorders of respiratory system, not elsewhere classified
In simple words: This code describes a serious lung problem that happens after surgery on the chest.The lungs aren't working properly, which means the body doesn't get enough oxygen.
J95.1, in the ICD-10-CM coding system, specifies acute pulmonary insufficiency that arises as a complication after thoracic (chest) surgery.This code signifies a severe impairment of gas exchange in the lungs, leading to inadequate oxygen supply and potentially elevated carbon dioxide levels in the blood, following a surgical procedure on the chest.
Example 1: A 65-year-old male patient undergoes a lobectomy for lung cancer. Post-operatively, he develops acute respiratory distress syndrome (ARDS), requiring mechanical ventilation. Code J95.1 would be appropriate in this scenario because the acute pulmonary insufficiency is a direct result of the thoracic surgery., A 40-year-old female patient has a surgical repair of a traumatic chest injury.Post-operatively she experiences hypoxemia and hypercapnia due to atelectasis and requires supplemental oxygen. J95.1 would be used in this case, where the lung failure is attributed to the chest surgery., A 70-year-old patient with COPD undergoes a thoracotomy for the treatment of a pleural effusion.Post-op, she develops acute respiratory failure necessitating intubation and mechanical ventilation in the ICU.In this scenario, the pre-existing lung condition could be considered in conjunction with code J95.1, reflecting both factors contributing to her post-surgical lung issue.
Thorough documentation is crucial.This should include the details of the thoracic surgery performed (e.g., type of procedure, date), pre-operative respiratory function assessments, post-operative respiratory status (e.g., arterial blood gases, oxygen saturation levels, respiratory rate, use of mechanical ventilation), and any interventions undertaken to address the acute pulmonary insufficiency.Details of any pre-existing conditions should also be noted.
** This code should only be applied when the acute pulmonary insufficiency is a direct result of the thoracic surgery.Other codes may be necessary to capture associated conditions or comorbidities.
- Payment Status: Active
- Specialties:Thoracic Surgery, Pulmonary Medicine, Anesthesiology, Critical Care Medicine
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center