AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2019 Issue 2; Ask The Editor

Hypovolemic Shock & Volume Depletion

A patient was admitted with hypovolemic shock due to volume depletion as a result of persistent nausea and vomiting. There is an Excludes1 note at category E86-, Volume depletion that prevents the reporting of dehydration or volume depletion with code R57.1, Hypovolemic shock. Not every patient who presents with dehydration suffers hypovolemic shock. However, code R57.1 is classified in Chapter 18, Symptoms, Signs and Abnormal Findings. Since codes from Chapter 18 are not reported when a related definitive diagnosis has been established by the provider, how can the severity of illness be captured if code R57.1 cannot be reported with codes E86.0, Dehydration and E86.9, Volume depletion, unspecified? ...

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