Did you know? Chronic Respiratory Failure is more common than you may think.
Criteria:
1. Continuous (24/7) home oxygen therapy (not just overnight). Note: No need to demonstrate hypoxemia as oxygen therapy only covered by insurance for home use if specific hypoxemia requirements have previously been met.
2. Normal serum pH with a pCO2 > 50 mmHg (i.e. – chronic compensation on an ABG) Note: An elevated serum bicarbonate level on a BMP indicates a compensatory metabolic alkalosis which may be due to a chronic respiratory acidosis (i.e. – the patient likely meets the criteria for chronic respiratory failure!)
3. Home ventilator usage with tracheostomy
| Not Sick | CC (Sick) | MCC (Very Sick) |
| No Severity | Moderate Severity | Maximal Severity |
| On home O2 | Chronic Respiratory Failure | Acute on Chronic Respiratory Failure |
The cause(s) of the respiratory failure should be stated, such as:
- COPD
- Interstitial lung diseases
- Obesity Hypoventilation Syndrome
- Cystic Fibrosis
- Muscular Dystrophies
- Pulmonary Hypertension
- Spinal cord injuries
| Clinical Language that is not effective for coding purposes | Highly effective language that will support metrics |
| COPD on home oxygen | COPD with chronic respiratory failure, on home oxygen |
