2025 ICD-10-CM code J96.92
(Active) Effective Date: N/A Respiratory Failure - Other diseases of the respiratory system Diseases of the respiratory system (J00-J99) Feed
Respiratory failure, unspecified with hypercapnia.
Medical necessity is established by the documented evidence of the respiratory system's inability to maintain sufficient gas exchange. This is often indicated by abnormal blood gas values, along with clinical signs and symptoms supporting the diagnosis.
Physicians use this code to document the specific type of respiratory failure a patient is experiencing. It is essential for accurate diagnosis and treatment planning. Respiratory therapists also use this code to track and manage patient care and resource allocation.
In simple words: This code indicates that a person's lungs are not effectively removing carbon dioxide from their body, leading to a buildup in the bloodstream.The specific reason for this is not identified by this code.
Respiratory failure, unspecified with hypercapnia. This code signifies a failure of the respiratory system's ability to maintain adequate oxygen and carbon dioxide levels in the blood, specifically with elevated carbon dioxide levels (hypercapnia). The underlying cause is not specified in this code.
Example 1: A patient with chronic obstructive pulmonary disease (COPD) presents with shortness of breath and altered mental status. Blood gas analysis reveals elevated carbon dioxide levels, indicating respiratory failure. In the absence of further specification, J96.92 is used., A patient post-operatively develops difficulty breathing. Arterial blood gas sampling shows high carbon dioxide levels. If no other specific cause is determined, J96.92 is the appropriate code., A patient with obesity hypoventilation syndrome experiences increasing daytime sleepiness and fatigue. Laboratory tests reveal high levels of carbon dioxide in the blood, consistent with respiratory failure. If no other specific information is available about the nature of the respiratory failure, J96.92 would be assigned.
Documentation should include arterial blood gas results demonstrating hypercapnia, signs and symptoms such as shortness of breath, altered mental status, and the clinical evaluation supporting the diagnosis of respiratory failure.Any underlying conditions or contributing factors should also be documented.
** 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)
- Specialties:Pulmonology, Critical Care Medicine, Internal Medicine, Hospitalists, Anesthesiology
- Place of Service:Inpatient Hospital, Emergency Room - Hospital, Skilled Nursing Facility, Nursing Facility, Hospice, Office, Home