2025 ICD-10-CM code J95.3
Chronic pulmonary insufficiency following surgery.
The medical necessity for the diagnosis of chronic pulmonary insufficiency following surgery is established through clear documentation of the causal relationship between the surgical procedure and the onset of persistent respiratory impairment. This should include evidence of diminished lung function (e.g., decreased FEV1/FVC ratio, reduced diffusing capacity) and symptoms (e.g., dyspnea, hypoxia) that impact the patient's quality of life and require ongoing medical intervention.
Pulmonologists, respiratory therapists, surgeons, and critical care specialists are commonly involved in the diagnosis, treatment, and management of this post-surgical complication.Their roles include assessment of lung function, oxygen therapy, and ventilator support. Close monitoring is essential. The physician should document detailed notes about the patient's respiratory function before, during and after surgery, noting any significant changes.
In simple words: This refers to long-term breathing difficulties and reduced lung function that develop after surgery.
This code describes a state of chronic reduced lung function and capacity for gas exchange, arising as a long-term consequence after a surgical procedure. It represents a persistent impairment in the ability of the lungs to adequately oxygenate the blood and remove carbon dioxide.
Example 1: A patient develops long-term breathing difficulties after undergoing open-heart surgery. After extensive evaluation, including pulmonary function tests and imaging studies, the patient is diagnosed with chronic pulmonary insufficiency as a direct result of the surgical procedure., A patient who underwent lung resection for cancer experiences persistent shortness of breath and reduced exercise tolerance months after the operation. Pulmonary function testing confirms significantly impaired lung capacity, indicating chronic pulmonary insufficiency., An elderly patient with pre-existing lung disease undergoes abdominal surgery and subsequently develops persistent difficulty breathing and impaired oxygen saturation levels, consistent with chronic pulmonary insufficiency exacerbated by the surgery.
Thorough documentation of pre-existing respiratory conditions, intraoperative ventilator management, post-operative respiratory status, arterial blood gas analysis, pulmonary function tests (PFTs), and chest imaging are crucial for accurate coding and medical necessity validation.
** Excludes2: Functional disturbances following cardiac surgery (I97.0, I97.1-)
- Payment Status: Active
- Specialties:Pulmonology, Respiratory Therapy, Thoracic Surgery, Critical Care Medicine, General Surgery
- Place of Service:Inpatient Hospital, Skilled Nursing Facility,Home