1. Bacterial infection, unspecified A49.9
Northern Westchester Hospital, Mount Kisco NY
April 2018

2. Query Opportunity -Unspecified bacterial infection can be reported if patient admitted with a fever, treated with antibiotics and documentation indicates suspected/probable infection of unknown etiology or suspected/probable culture negative bacterial infection. -Look for a specific organism on culture reports. If unspecified bacterial infection is linked to a specific disease process such as pneumonia or sepsis, only the disease process would be reported. Excludes: bacteremia NOS (R78.81)

3. Case Study
Summary: 79 Year Old female dialysis patient, presents to ED for malaise, fever for 3 days & poor PO intake. Patient started on IV Zithromax inpatient x2 days and discharged home on PO antibiotics to complete course.
Opportunity: Physician Notes and Discharge Summary read, ‘’1) Fever, unknown etiology, viral panel negative appetite improving, will convert IV antibiotics to PO and have patient follow up with PCP in 3 days.’’
Query: Your patient has the documented diagnosis of Fever. Please clarify, if the patient’s fever is known or suspected to be due to one of the following:
• Suspected Bacterial Infection with unclear etiology • Other • N/A • Unable to Determine

4. DRG 864, Fever (R50.9), wt 0.8701 which does not accept CC or MCC
Impact: Successful query for possible bacterial infection allows us to move out of the symptom code of
DRG 864, Fever (R50.9), wt which does not accept CC or MCC
This then moves us to DRG 869 Other Infectious & Parasitic Diseases Diagnosis W/O CC/MCC --Bacterial infection, unspecified (A49.9) wt
which DOES allow us to capture CC/MCC –
adding the patients ESRD status, MCC,
changes this to a weight of DRG 867
THAT IS A WEIGHT CHANGE FROM 

6. Thank You
January 18, 2018