Respiratory Failure & Vents Flashcards
7 cards from real CCDS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Respiratory Failure & Vents flashcards as text
A patient is documented as having 'acute-on-chronic hypoxic respiratory failure.' For CDI purposes, what does this combined term indicate?
Answer: Both the acute and chronic conditions are coded separately
Acute-on-chronic respiratory failure is coded with both acute (J96.01) and chronic (J96.11) codes, or the combined code J96.21, per ICD-10-CM guidelines.
Which ventilator setting directly controls the volume of air delivered with each breath in volume-controlled ventilation?
Answer: Tidal volume
Tidal volume (Vt) is the parameter set by the clinician in volume-controlled modes to determine the amount of air delivered per breath.
A CCDS notes a patient on mechanical ventilation for 36 hours. Which CDI action is most appropriate regarding duration-based code assignment?
Answer: Query the physician to confirm total hours to determine if the 96-hour threshold will be met
Since 36 hours is approaching the 96-hour threshold (5Z09.3 vs. 5Z09.4 under PCS), the CCDS should monitor and query if the total duration crosses 96 hours.
A patient develops respiratory failure secondary to a heroin overdose. What is the correct principal diagnosis sequencing?
Answer: Heroin poisoning as principal diagnosis
Per ICD-10-CM guidelines for poisoning, the poisoning code (heroin overdose) is sequenced first, with respiratory failure as an additional diagnosis.
What does the term 'assist-control ventilation' describe in clinical practice?
Answer: A mode providing a set minimum rate with full ventilator support for every breath, patient-initiated or not
Assist-control (AC) delivers a guaranteed minimum number of breaths and provides full support (volume or pressure) for any additional patient-initiated breaths.
A patient with COPD is admitted with acute hypercapnic respiratory failure. The provider documents 'COPD exacerbation with respiratory failure.' Which code should be sequenced as principal diagnosis?
Answer: J44.1 – COPD with acute exacerbation
ICD-10-CM guideline I.C.10.a directs that COPD with acute exacerbation (J44.1) is sequenced as principal diagnosis when respiratory failure is also present, unless the respiratory failure is more resource-intensive.
Which clinical indicator would most strongly support CDI querying for acute respiratory failure in a patient on supplemental oxygen?
Answer: PaO2 of 55 mmHg on room air with increased work of breathing
A PaO2 of 55 mmHg with increased work of breathing meets clinical criteria for acute hypoxic respiratory failure and supports a CDI query.