Chronic Respiratory Failure

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Did you know? Chronic Respiratory Failure is more common than you may think.

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:
• 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

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