CODES.AND.STUFF

Dehydration occurs when the body’s normal water content is reduced due to either decreased water intake or fluid loss. Fluid can be lost through vomiting, diarrhoea, excessive sweating or through urinating too frequently. Dehydration can be described as mild, moderate or severe depending on the percentage of body weight lost due to fluid loss. Dehydration occurs when there is a 1% or greater reduction in body weight due to fluid loss. Mild to moderate dehydration causes dizziness, headaches, tiredness and dry mouth. For mild dehydration, drinking plenty of water may be all that is needed. With moderate and severe dehydration, lost electrolytes must be replaced. Oral rehydration solutions that contain appropriate amounts of electrolytes can be given to patients with moderate dehydration. Severe dehydration is a life threatening emergency causing confusion, seizures, shock and severe damage to internal organs and can lead to coma, brain damage and death if left untreated. Severe dehydration requires treatment with intravenous solutions containing sodium chloride.

• Dehydration must always be coded, using the appropriate ICD-10 code, where it is confirmed to be severe dehydration, or where dehydration has been treated with intravenous fluids.

Dehydration in newborns is always considered a serious medical issue. Newborns have a low body weight and are sensitive to even small amounts of fluid loss. Newborns with dehydration may not have enough fluids to supply the organs with blood, which can cause shock. Dehydration can develop quickly in newborns and is more serious than in adults, because newborns use more water and their kidneys don’t conserve water as efficiently as adults.

 • When a newborn has a stated diagnosis of dehydration this must always be captured in the coded record, using the appropriate ICD-10 code.  

Hypovolaemia (also known as hypovolemia) is an abnormal decrease in blood volume or an abnormal decrease in the volume of blood plasma. Hypovolaemia can occur as a result of dehydration, severe burns, vomiting or severe blood loss. Hypovolaemia can progress to hypovolaemic shock, in which organs begin to fail as a result of reduced blood and oxygen levels. Hypovolaemic shock requires emergency treatment to replace the lost blood and body fluids as soon as possible using intravenous fluids; blood transfusion may also be required.

• Hypovolaemia must always be coded, using the appropriate ICD-10 code, when it is confirmed to have been treated with intravenous fluids or blood transfusion.

Implementation date: 01/04/2011

Date published: 03/2011 (Volume 7 Issue 9)

Coding Clinic, NHS Classifications Service

www.connectingforhealth.nhs.uk/codingclinic

Related articles

• EatingWell: How Water Affects 7 Parts Of Your Body (huffingtonpost.com)
• What Counts as Water? How to Stay Hydrated (webmd.com)

Tags: Metabolic Disorders