Understanding bacteremia, bloodstream infection, and blood infection diagnosis, treatment, and clinical documentation is crucial for healthcare professionals. This resource provides information on bacteremia symptoms, causes, ICD-10 codes, medical coding guidelines, and best practices for accurate clinical documentation and patient care. Learn about blood culture testing, antibiotic treatment options, and sepsis management related to bacteremia. Explore relevant information for physicians, nurses, and other medical professionals involved in the diagnosis and management of bacteremia and related bloodstream infections.
Also known as
Other bacterial diseases
Covers other bacterial infections, including septicemia.
Bacteremia
Specifically identifies a bacterial infection in the bloodstream.
Certain infectious and parasitic diseases
Broad category encompassing various infectious diseases, including bacteremia.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the bacteremia associated with an obstetric cause during pregnancy, childbirth, or the puerperium?
When to use each related code
| Description |
|---|
| Bacteria in the bloodstream. |
| Systemic inflammatory response to infection. |
| Infection originating from a localized site. |
Confusing bacteremia with sepsis or severe sepsis can lead to inaccurate coding and DRG assignment.
Insufficient documentation to support bacteremia diagnosis may cause coding and billing errors.
Lack of specificity regarding the causative organism impacts coding accuracy and reimbursement.
Q: What are the most effective empiric antibiotic treatment strategies for suspected gram-negative bacteremia in critically ill adults, considering current resistance patterns?
A: Empiric antibiotic therapy for suspected gram-negative bacteremia in critically ill adults must cover a broad spectrum of potential pathogens, including resistant organisms like *Pseudomonas aeruginosa* and *Enterobacteriaceae* producing extended-spectrum beta-lactamases (ESBLs) or carbapenemases. Current guidelines, such as those from the Infectious Diseases Society of America (IDSA) and local antibiograms, recommend initial treatment with a combination of a beta-lactam with activity against *Pseudomonas* (e.g., piperacillin-tazobactam, cefepime, meropenem, imipenem-cilastatin) and an aminoglycoside (e.g., gentamicin, tobramycin, amikacin). For patients with risk factors for carbapenem-resistant *Enterobacteriaceae* (CRE), alternative options include ceftazidime-avibactam, meropenem-vaborbactam, or colistin. De-escalation of therapy based on culture results and clinical response is crucial to minimize the emergence of resistance. Consider implementing rapid diagnostic testing, such as PCR or MALDI-TOF, to facilitate prompt identification of the causative pathogen and guide targeted antibiotic therapy. Explore how antimicrobial stewardship programs can optimize antibiotic use in your ICU.
Q: How do I differentiate between true bacteremia and contamination in blood cultures drawn from patients with suspected bloodstream infections?
A: Differentiating true bacteremia from blood culture contamination is a common challenge. Clinicians should consider several factors. True bacteremia is more likely with multiple positive blood cultures, especially if they grow the same organism. The clinical presentation of the patient, including fever, chills, hypotension, and other signs of systemic infection, supports the diagnosis of bacteremia. Common skin contaminants include coagulase-negative staphylococci, *Corynebacterium* species, *Propionibacterium acnes*, and *Bacillus* species. However, these organisms can occasionally cause true infection, especially in immunocompromised patients or those with indwelling medical devices. The time to positivity in blood cultures can also be helpful; rapid growth of pathogens typically suggests true bacteremia. Repeating blood cultures after appropriate skin disinfection helps rule out contamination. Learn more about best practices for blood culture collection and interpretation to improve diagnostic accuracy.
Patient presents with signs and symptoms suggestive of bacteremia, also known as a bloodstream infection or blood infection. Clinical manifestations include fever, chills, rigors, tachycardia, hypotension, and altered mental status. The patient's medical history includes [relevant comorbidities, e.g., diabetes, indwelling catheter, recent surgery]. Physical examination reveals [relevant findings, e.g., warm skin, flushed appearance, murmur]. Preliminary differential diagnosis includes sepsis, septic shock, and other infectious processes. Blood cultures have been drawn and sent for laboratory analysis to identify the causative organism and determine antibiotic susceptibility. Empiric antibiotic therapy has been initiated with [antibiotic name and dosage] pending culture results. The patient's condition is being closely monitored for signs of clinical deterioration. Further diagnostic workup may include complete blood count (CBC) with differential, procalcitonin, lactate, and imaging studies as clinically indicated. Treatment plan includes intravenous fluids, hemodynamic support, and adjustment of antibiotics based on culture results and clinical response. Patient education provided regarding bacteremia symptoms, treatment, and potential complications. Coding considerations include ICD-10-CM code for bacteremia (B95.6) and appropriate CPT codes for blood cultures and other diagnostic and therapeutic procedures performed. Differential diagnosis considerations for billing and medical necessity documentation include sepsis, severe sepsis, and septic shock, to be documented appropriately if suspected or confirmed.