Q&A: Educating physicians on need to document chronic respiratory failure
CDI Strategies, April 1, 2009
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Q: I’ve heard that when a patient is on home oxygen we should query the physician for chronic respiratory failure. Often in these cases the physician will document a diagnosis of chronic obstructive pulmonary disease (COPD) and does not want to document chronic respiratory failure because he or she thinks the COPD diagnosis is enough, and that it is redundant to write anything else. Other than explaining to the physician that we code chronic respiratory failure separately from the COPD, what else can we do to help them understand the difference between these two diagnoses?
A: As not all patients with COPD require chronic oxygen therapy, it is important to document chronic respiratory failure to denote the level of severity in a patient with COPD. There is no other way of distinguishing patients with severe COPD from other degrees of COPD, other than by documenting associated co-morbid illnesses such as chronic respiratory failure.
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