Understanding Fever (Pyrexia) diagnosis, documentation, and medical coding? Find information on febrile response symptoms, clinical findings, ICD-10 codes related to fever, and best practices for healthcare professionals. Learn about fever management, treatment, and differential diagnosis for accurate clinical documentation and coding.
Also known as
Symptoms and signs involving general
Includes fever of unknown origin and other general symptoms.
Certain infectious and parasitic diseases
Fever can be a symptom of many infectious diseases.
Diseases of the circulatory system
Some circulatory diseases can cause fever as a secondary symptom.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the fever a symptom of another condition?
Yes
Is the underlying condition documented?
No
Is the fever drug-induced?
When to use each related code
| Description |
|---|
| Elevated body temperature. |
| Body temperature >100.4F (38C) rectally. |
| Body temperature below normal range. |
Coding fever without specifying cause (e.g., infection, drug-induced) leads to inaccurate clinical documentation and impacts reimbursement.
Lack of specific temperature documentation and associated symptoms hinders accurate severity assessment and coding for quality reporting.
Miscoding fever (regulated by hypothalamus) as hyperthermia (external causes) impacts patient safety and skews epidemiological data.
Q: What are the evidence-based best practices for differentiating fever of unknown origin (FUO) in adults from other febrile illnesses?
A: Differentiating fever of unknown origin (FUO) requires a systematic approach. The classic criteria include a temperature of 38.3°C (101°F) or higher on several occasions, persisting for at least 3 weeks, and remaining undiagnosed after one week of inpatient investigation or 3 outpatient visits. Crucially, this involves excluding more common causes of fever like infections (e.g., occult abscesses, tuberculosis), malignancies (e.g., lymphoma, leukemia), and autoimmune diseases (e.g., adult-onset Still's disease). Best practices involve a thorough history and physical exam, focusing on travel history, exposures, medications, and symptoms. Targeted laboratory investigations should be guided by clinical suspicion and may include complete blood count, inflammatory markers (ESR, CRP), blood cultures, urinalysis, and imaging studies such as chest X-ray, CT scan, or MRI. Consider implementing a multidisciplinary approach involving infectious disease specialists, rheumatologists, and oncologists as needed. Explore how advanced diagnostic techniques like PET scans or biopsies can be utilized in complex FUO cases.
Q: How should I manage a patient presenting with fever and neutropenia in the outpatient setting, and when is hospitalization indicated?
A: Managing fever and neutropenia in the outpatient setting requires careful risk stratification. Low-risk patients, defined by the Multinational Association for Supportive Care in Cancer (MASCC) risk index, may be eligible for oral antibiotics and close monitoring. Factors considered in risk stratification include the severity of neutropenia (absolute neutrophil count < 500/µL), duration of neutropenia, patient age, comorbidities, and presenting symptoms. High-risk patients, particularly those with severe neutropenia, significant comorbidities, or signs of systemic infection (e.g., hypotension, altered mental status), require immediate hospitalization and empiric broad-spectrum intravenous antibiotics. Outpatient management requires close follow-up, typically within 24 hours, and clear instructions for returning to the hospital if symptoms worsen. Learn more about the MASCC risk index and its application in clinical practice. Consider implementing standardized protocols for managing febrile neutropenia in your outpatient setting to ensure consistent and evidence-based care.
Patient presents with fever (pyrexia, febrile response). Onset, duration, and associated symptoms are key factors in determining the etiology of the fever. Temperature measurement was obtained via [route of measurement: e.g., oral, tympanic, axillary, rectal] and recorded as [temperature value] degrees Celsius. Patient reports [associated symptoms: e.g., chills, rigors, sweating, malaise, headache, myalgia, arthralgia, cough, sore throat, abdominal pain, nausea, vomiting, diarrhea, rash]. Differential diagnosis includes infection (viral, bacterial, fungal, parasitic), inflammatory conditions (autoimmune disorders, rheumatologic diseases), malignancy, drug-induced fever, and heat stroke. Physical examination findings include [relevant findings: e.g., tachycardia, tachypnea, flushed skin, diaphoresis, lymphadenopathy, tenderness to palpation]. Laboratory tests ordered include [list tests: e.g., complete blood count with differential, comprehensive metabolic panel, blood cultures, urinalysis, chest x-ray]. Treatment plan includes [treatment interventions: e.g., antipyretics, intravenous fluids, antibiotics if indicated, further diagnostic testing based on clinical suspicion]. Patient education provided regarding monitoring temperature, managing symptoms, and recognizing signs of potential complications. Follow-up care is recommended to assess response to treatment and further evaluate the underlying cause of the fever. ICD-10 code R50.9 (Fever, unspecified) may be considered, with additional codes for specific etiologies if identified. Evaluation and management coding will be based on the complexity of the patient presentation and medical decision making.