Learn about ESBL urinary tract infection (UTI) diagnosis, including clinical documentation and medical coding for ESBL UTI and Extended Spectrum Beta-Lactamase UTI. This resource provides information on healthcare best practices for identifying and managing ESBL producing bacteria in UTIs. Find details relevant to extendedspectrum betalactamase uti and improve your understanding of this specific type of infection.
Also known as
Urinary tract infection, site not specified
Infection affecting any part of the urinary tract.
Other specified bacterial agents as the cause of diseases classified elsewhere
Diseases caused by bacterial agents not classified elsewhere.
Resistance to other antimicrobials
Resistance to antimicrobial drugs not classified elsewhere.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the UTI confirmed?
Yes
Is ESBL production confirmed?
No
Do not code a UTI. Evaluate for other diagnoses.
When to use each related code
| Description |
|---|
| UTI with ESBL-producing bacteria. |
| Uncomplicated UTI, typically from E. coli. |
| Complicated UTI involving kidney or systemic infection. |
Lack of specific ESBL organism documented can lead to coding and billing errors. CDI can query for clarification.
Distinguishing between true infection and colonization is crucial for accurate coding and antibiotic stewardship.
Insufficient documentation of UTI symptoms, lab results, and ESBL confirmation can lead to coding denials and lost revenue.
Q: What are the most effective empiric antibiotic treatment options for suspected ESBL UTI in hospitalized patients, considering resistance patterns and local antibiograms?
A: Empiric antibiotic treatment for suspected ESBL UTI in hospitalized patients requires careful consideration of local resistance patterns and antibiogram data. Carbapenems (e.g., ertapenem, imipenem, meropenem) are often considered first-line due to their broad-spectrum activity against ESBL-producing organisms. However, increasing carbapenem resistance warrants judicious use. Alternative options with demonstrated efficacy in some settings include fosfomycin, nitrofurantoin (if susceptible), and newer beta-lactam/beta-lactamase inhibitor combinations like ceftazidime-avibactam or ceftolozane-tazobactam. Ultimately, the choice of empiric therapy should be guided by institutional guidelines, patient-specific factors (e.g., allergies, renal function), and local susceptibility data. Explore how antibiotic stewardship programs can optimize ESBL UTI management and minimize resistance development.
Q: How can I differentiate between complicated and uncomplicated ESBL UTI in a clinical setting, and what are the implications for treatment duration and choice of antibiotics?
A: Differentiating between complicated and uncomplicated ESBL UTI hinges on the presence of factors that increase the risk of treatment failure. Uncomplicated UTIs typically occur in otherwise healthy, non-pregnant females with a normal urinary tract. Complicated UTIs, on the other hand, are associated with factors such as male gender, pregnancy, indwelling catheters, urinary tract abnormalities (e.g., stones, obstruction), immunosuppression, or recent instrumentation. This distinction is crucial as complicated UTIs often require longer treatment durations (typically 7-14 days) and may necessitate broader-spectrum antibiotics like carbapenems or beta-lactam/beta-lactamase inhibitor combinations. Uncomplicated ESBL UTIs might be managed with shorter courses of antibiotics like fosfomycin or nitrofurantoin (if susceptible). Consider implementing a standardized approach to UTI classification in your practice to ensure appropriate treatment strategies. Learn more about the role of urine cultures in guiding antibiotic therapy for ESBL UTIs.
Patient presents with symptoms consistent with a urinary tract infection complicated by the presence of extended-spectrum beta-lactamase (ESBL) producing organisms. Symptoms include dysuria, frequency, urgency, and suprapubic pain. Patient also reports malodorous urine and possible hematuria. No fever or chills are reported. Medical history significant for recurrent UTIs and recent antibiotic use within the past three months. Physical examination reveals mild suprapubic tenderness. Urine dipstick positive for leukocyte esterase and nitrites. Urine culture ordered to confirm ESBL UTI diagnosis and identify the causative organism. Given the suspected ESBL production, empiric antibiotic therapy initiated with a carbapenem, pending culture and sensitivity results. Patient education provided regarding antibiotic compliance, hydration, and potential complications of ESBL infections. Differential diagnosis includes uncomplicated UTI, pyelonephritis, and sexually transmitted infections. ICD-10 code N39.0 will be used with an additional code to specify the ESBL-producing organism upon culture confirmation. CPT codes for urinalysis, urine culture, and evaluation and management will be billed accordingly. Follow-up scheduled in one week to review culture results and assess treatment response. Treatment plan may be adjusted based on the antibiogram.