Did you know? COPD is the #9 most denied admission diagnosis by the RAC.

COPD is a chronic condition and should not be the main reason for admission to the hospital UNLESS one of these TWO issues is present:

Acute Exacerbation

  • Document acute exacerbation of COPD if admission is medically necessary and steroids and frequent nebulization treatments are required

Acute Respiratory Failure

  • Document when the clinical criteria are present
    • Requires 2 of the following 3:
      1. Respiratory Distress – document this in the physical exam
      2. PaO2 < 60mmHg (pulse ox < 88%) or higher oxygen requirements for COPD patients on oxygen
      3. PaCO2 > 50 mmHg with a pH < 7.35 (means acute)

Chronic Respiratory Failure
DON’T FORGET to evaluate all patients with COPD for the presence of Chronic Respiratory Failure:
1. Home oxygen therapy for more than 16 hours a day (i.e. – not just at night)
2. PCO2 > 50 mmHg with a normal serum pH (indicating chronic compensation)

  • Chronic Respiratory Failure is a commonly missed diagnosis which greatly improves your patients’ severity of illness.
  • Don’t forget to document Acute on Chronic Respiratory Failure when present.

Download the complete tip, COPD.