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
No Severity |
CC (Sick)
Moderate Severity |
MCC (Very Sick)
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 |
Download the complete tip, Chronic Respiratory Failure.