HCPro, JustCoding Inpatient - 2016 Issue 37 (October)

Q&A: Sequencing for flu, pneumonia, and asthma

October 4th, 2016

Q: I am never sure of correct sequencing when the admission is for flu, pneumonia, and asthma.

The patient presented in the emergency department (ED) with shortness of breath, still tight after nebulizer treatment in the emergency room. The patient was kept for observation for one day, then was admitted. Documentation includes:

• Fever 101.8 in ED; respiratory rate (RR) 24; white blood cell count (WBC) 12.6
• Influenza and upper respiratory tract infection
• Mild persistent asthma in exacerbation due to the above (wheezing, tachycardia in the ED, 130s); acute hypoxic respiratory failure (PO 90%).
• Superimposed RLL community-acquired pneumonia (CAP), per chest x-ray

Can you suggest proper sequencing and if queries are needed?

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