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AHA Coding Clinic® for ICD-9 - 2009 Issue 3; Ask the Editor

Near Drowning with Acute Respiratory Failure

A 12-year-old girl was found submerged in a pool. The event was unwitnessed with an estimated time of 15 minutes spent underwater. Patient was unresponsive when pulled from the water and given cardiopulmonary resuscitation (CPR) by bystanders. When paramedics arrived, she was combative and moving all extremities. She was intubated and underwent bag-valve mask ventilations. She was profoundly hypoxemic and hypercapnic in the emergency department (ED), so she was placed on mechanical ventilator. Patient was recently diagnosed with first-time seizure six months ago, so seizure activity may have initiated the near drowning incident. She was not on antiepileptics. The provider diagnoses include drowning, acute respiratory distress, respiratory acidosis, hypoxemic and hypercapnic respiratory failure. What is the principal diagnosis? ...

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