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)
- Requires 2 of the following 3:
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.