O89.01 - Aspiration pneumonitis due to anesthesia during the puerperium

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:

• Maternity diagnoses - The Medicare Code Editor detects inconsistencies in maternity cases by checking a patient's age and any diagnosis on the patient's record. The maternity code edits apply to patients age ange is 9–64 years inclusive (e.g., diabetes in pregnancy, antepartum pulmonary complication).
• Diagnoses for females only - The Medicare Code Editor detects inconsistencies between a patient’s sex and any diagnosis on the patient’s record, these edits apply to FEMALES only .

Convert to ICD-9 Code

Patient Education

Anesthesia

What is anesthesia?

Anesthesia is the use of medicines to prevent pain during surgery and other procedures. These medicines are called anesthetics. They may be given by injection, inhalation, topical lotion, spray, eye drops, or skin patch. They cause you to have a loss of feeling or awareness.

What is anesthesia used for?

Anesthesia may be used in minor procedures, such as filling a tooth. It could be used during childbirth or procedures such as colonoscopies. And it is used during minor and major surgeries.

In some cases, a dentist, nurse, or doctor may give you an anesthetic. In other cases, you may need an anesthesiologist. This is a doctor who specializes in giving anesthesia.

What are the types of anesthesia?

There are several different types of anesthesia:

• Local anesthesia numbs a small part of the body. It might be used on a tooth that needs to be pulled or on a small area around a wound that needs stitches. You are awake and alert during local anesthesia.
• Regional anesthesia is used for larger areas of the body such as an arm, a leg, or everything below the waist. You may be awake during the procedure, or you may be given sedation. Regional anesthesia may be used during childbirth, a Cesarean section (C-section), or minor surgeries.
• General anesthesia affects the whole body. It makes you unconscious and unable to move. It is used during major surgeries, such as heart surgery, brain surgery, back surgery, and organ transplants.

What are the risks of anesthesia?

Anesthesia is generally safe. But there can be risks, especially with general anesthesia, including:

• Heart rhythm or breathing problems
• An allergic reaction to the anesthesia
• Delirium after general anesthesia. Delirium makes people confused. They may be unclear about what is happening to them. Some people over the age of 60 have delirium for several days after surgery. It can also happen to children when they first wake up from anesthesia.
• Awareness when someone is under general anesthesia. This usually means that the person hears sounds. But sometimes they can feel pain. This is rare.

Pneumonia

What is pneumonia?

Pneumonia is an infection in one or both of the lungs. It causes the air sacs of the lungs to fill up with fluid or pus. It can range from mild to severe, depending on the type of germ causing the infection, your age, and your overall health.

What causes pneumonia?

Bacterial, viral, and fungal infections can cause pneumonia.

Bacteria are the most common cause. Bacterial pneumonia can occur on its own. It can also develop after you've had certain viral infections such as a cold or the flu. Several different types of bacteria can cause pneumonia, including:

• Streptococcus pneumoniae
• Legionella pneumophila; this pneumonia is often called Legionnaires' disease
• Mycoplasma pneumoniae
• Chlamydia pneumoniae
• Haemophilus influenzae

Viruses that infect the respiratory tract may cause pneumonia. Viral pneumonia is often mild and goes away on its own within a few weeks. But sometimes it is serious enough that you need to get treatment in a hospital. If you have viral pneumonia, you are at risk of also getting bacterial pneumonia. The different viruses that can cause pneumonia include:

• Respiratory syncytial virus (RSV)
• Some common cold and flu viruses
• SARS-CoV-2, the virus that causes COVID-19

Fungal pneumonia is more common in people who have chronic health problems or weakened immune systems. Some of the types include:

• Pneumocystis pneumonia (PCP)
• Coccidioidomycosis, which causes valley fever
• Histoplasmosis
• Cryptococcus

Who is at risk for pneumonia?

Anyone can get pneumonia, but certain factors can increase your risk:

• Age; the risk is higher for children who are age 2 and under and adults age 65 and older
• Exposure to certain chemicals, pollutants, or toxic fumes
• Lifestyle habits, such as smoking, heavy alcohol use, and malnourishment
• Being in a hospital, especially if you are in the ICU. Being sedated and/or on a ventilator raises the risk even more.
• Having a lung disease
• Having a weakened immune system
• Have trouble coughing or swallowing, from a stroke or other condition
• Recently being sick with a cold or the flu

What are the symptoms of pneumonia?

The symptoms of pneumonia can range from mild to severe and include:

• Fever
• Chills
• Cough, usually with phlegm (a slimy substance from deep in your lungs)
• Shortness of breath
• Chest pain when you breathe or cough
• Nausea and/or vomiting
• Diarrhea

The symptoms can vary for different groups. Newborns and infants may not show any signs of the infection. Others may vomit and have a fever and cough. They might seem sick, with no energy, or be restless.

Older adults and people who have serious illnesses or weak immune systems may have fewer and milder symptoms. They may even have a lower than normal temperature. Older adults who have pneumonia sometimes have sudden changes in mental awareness.

What other problems can pneumonia cause?

Sometimes pneumonia can cause serious complications such as:

• Bacteremia, which happens when the bacteria move into the bloodstream. It is serious and can lead to septic shock.
• Lung abscesses, which are collections of pus in cavities of the lungs
• Pleural disorders, which are conditions that affect the pleura. The pleura is the tissue that covers the outside of the lungs and lines the inside of your chest cavity.
• Kidney failure
• Respiratory failure

How is pneumonia diagnosed?

Sometimes pneumonia can be hard to diagnose. This is because it can cause some of the same symptoms as a cold or the flu. It may take time for you to realize that you have a more serious condition.

Your health care provider may use many tools to make a diagnosis:

• A medical history, which includes asking about your symptoms
• A physical exam, including listening to your lungs with a stethoscope
• Various tests, such as
  • A chest x-ray
  • Blood tests such as a complete blood count (CBC) to see if your immune system is actively fighting an infection
  • A Blood culture to find out whether you have a bacterial infection that has spread to your bloodstream

If you are in the hospital, have serious symptoms, are older, or have other health problems, you may also have more tests, such as:

• Sputum test, which checks for bacteria in a sample of your sputum (spit) or phlegm (slimy substance from deep in your lungs).
• Chest CT scan to see how much of your lungs is affected. It may also show if you have complications such as lung abscesses or pleural effusions.
• Pleural fluid culture, which checks for bacteria in a fluid sample that was taken from the pleural space
• Pulse oximetry or blood oxygen level test, to check how much oxygen is in your blood
• Bronchoscopy, a procedure used to look inside your lungs' airways

What are the treatments for pneumonia?

Treatment for pneumonia depends on the type of pneumonia, which germ is causing it, and how severe it is:

• Antibiotics treat bacterial pneumonia and some types of fungal pneumonia. They do not work for viral pneumonia.
• In some cases, your provider may prescribe antiviral medicines for viral pneumonia
• Antifungal medicines treat other types of fungal pneumonia

You may need to be treated in a hospital if your symptoms are severe or if you are at risk for complications. While there, you may get additional treatments. For example, if your blood oxygen level is low, you may receive oxygen therapy.

It may take time to recover from pneumonia. Some people feel better within a week. For other people, it can take a month or more.

Can pneumonia be prevented?

Vaccines can help prevent pneumonia caused by pneumococcal bacteria or the flu virus. Having good hygiene, not smoking, and having a healthy lifestyle may also help prevent pneumonia.

NIH: National Heart, Lung, and Blood Institute

Postpartum Care

Taking home a new baby is one of the happiest times in a woman's life. But it also presents both physical and emotional challenges. :

• Get as much rest as possible. You may find that all you can do is eat, sleep, and care for your baby. And that is perfectly okay. You will have spotting or bleeding, like a menstrual period, off and on for up to six weeks.
• You might also have swelling in your legs and feet, feel constipated, have menstrual-like cramping. Even if you are not breastfeeding, you can have milk leaking from your nipples, and your breasts might feel full, tender, or uncomfortable.
• Follow your doctor's instructions on how much activity, like climbing stairs or walking, you can do for the next few weeks.
• Doctors usually recommend that you abstain from sexual intercourse for four to six weeks after birth.

In addition to physical changes, you may feel sad or have the "baby blues." If you are extremely sad or are unable to care for yourself or your baby, you might have a serious condition called postpartum depression.

Dept. of Health and Human Services Office on Women's Health

Code History

• FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
• FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
• FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)