Tip: Differentiate between bacteremia, septicemia coding

Over the years all authoritative coding sources referred to sepsis and septicemia as the same condition. Finally, in 2008, these coding references stated that sepsis and septicemia are two different conditions:

• Sepsis is a body response to dead tissue mediated by the release of kinins from macrophages. The condition has no indication of the presence of bacteria in the bloodstream.
• Septicemia is defined as a condition caused by the presence of bacteria, fungi, viruses, or other pathogenic organisms in the bloodstream with no indication that sepsis exists.

When patients have sepsis and bacteremia, and the physician documents both conditions in the medical record, coders can report a code from the 038 series. But not all cases of bacteremia meet the existing definitions of sepsis. And even if all cases did meet the existing definition, infectious disease physicians are calling it all bacteremia even when there is a positive blood culture in a significant infection.

Editor’s note: The preceding content was excerpted from June’s featured article on the ACDIS web site. Featured articles are archived and available for free in the Helpful Resources section.

This article was written by Robert S. Gold, MD, CEO of DCBA, Inc., a consulting firm in Atlanta. Contact him by e-mail at DCBAInc@cs.com.