2025 ICD-10-CM code J96.0
Acute respiratory failure.A condition where the lungs cannot effectively remove carbon dioxide from the blood or take in enough oxygen.
Medical necessity for services related to acute respiratory failure hinges on the severity of the condition, the need for respiratory support, and the treatment required to manage the underlying cause.The documentation must clearly support the clinical rationale for interventions like mechanical ventilation, oxygen therapy, and medications.
Diagnosis and treatment of acute respiratory failure usually fall under the purview of critical care specialists, pulmonologists, or hospitalists, depending on the setting.Managing this condition involves addressing the underlying cause, providing respiratory support (e.g., oxygen therapy, mechanical ventilation), and monitoring blood gases to ensure adequate oxygenation and ventilation. It is a multifaceted clinical responsibility that demands prompt and expert medical intervention.
In simple words: Acute respiratory failure is a serious condition where the lungs suddenly can't get enough oxygen into the blood or can't remove carbon dioxide from the blood efficiently enough.
Acute respiratory failure is a condition characterized by the lungs' inability to perform their primary function of gas exchange, either by insufficiently removing carbon dioxide from the blood (hypercapnia) or inadequately taking in oxygen (hypoxia), or both. This critical condition can arise from various underlying causes affecting any part of the respiratory system, from the airways to the alveoli, or from problems originating outside the respiratory system but impacting lung function.Excludes1: acute respiratory distress syndrome (J80), cardiorespiratory failure (R09.2), newborn respiratory distress syndrome (P22.0), postprocedural respiratory failure (J95.82-), respiratory arrest (R09.2), respiratory arrest of newborn (P28.81), respiratory failure of newborn (P28.5).
Example 1: A patient with severe pneumonia develops acute respiratory failure due to fluid buildup in the lungs, requiring mechanical ventilation., A patient with a drug overdose experiences respiratory depression, leading to acute respiratory failure requiring intubation and assisted ventilation., A patient with chronic obstructive pulmonary disease (COPD) experiences an acute exacerbation, leading to acute respiratory failure due to worsening airflow obstruction.
Documentation for J96.0 should include a detailed history of the present illness, physical exam findings (e.g., respiratory rate, oxygen saturation, auscultation of breath sounds), arterial blood gas results demonstrating hypoxemia and/or hypercapnia, and imaging studies (e.g., chest X-ray, CT scan) if performed.It's crucial to specify the underlying cause of the acute respiratory failure.
- Specialties:Pulmonary Disease, Critical Care Medicine, Internal Medicine, Hospital Medicine, Emergency Medicine
- Place of Service:Inpatient Hospital, Emergency Room - Hospital, Intensive Care Unit