J95.01
BillableHemorrhage from tracheostomy stoma
HCC Category Mapping
V28HCC 211 — Respirator Dependence/Tracheostomy Status/Complications
0.450V24HCC 82 — Respirator Dependence/Tracheostomy Status
1.241ESRDHCC 82 — Respirator Dependence/Tracheostomy Status
0.000What This Code Means
Bleeding that occurs from the opening (stoma) created in the windpipe during a tracheostomy procedure. This is a complication that can happen when the tracheostomy tube irritates or damages blood vessels in the area.
Coding Tips
- •This code should only be used when bleeding is specifically documented as originating from the tracheostomy stoma site, not from other respiratory tract locations
- •Verify the tracheostomy is present and active; if the stoma has been closed or the patient no longer has a tracheostomy, this code would not be appropriate
Clinical Significance
Hemorrhage from tracheostomy stoma is a potentially life-threatening complication where bleeding occurs at the surgical opening in the trachea. The severity ranges from minor stomal bleeding to catastrophic hemorrhage from tracheo-innominate artery fistula. This complication requires urgent evaluation and may necessitate surgical intervention, reflecting high acuity of care.
Documentation Requirements
- ✓Documentation of bleeding specifically from the tracheostomy stoma site
- ✓Severity of hemorrhage (minor oozing vs. significant bleeding vs. massive hemorrhage)
- ✓Assessment for underlying cause (granulation tissue, tube erosion, tracheo-innominate fistula, coagulopathy)
- ✓Treatment provided (local pressure, cauterization, surgical exploration, blood transfusion)
- ✓Active tracheostomy status documentation
Commonly Confused Codes
J95.00 — Unspecified tracheostomy complication is less specific and should not be used when hemorrhage is documentedJ95.02 — Infection of tracheostomy stoma may co-exist with bleeding but is a different primary complicationR04.89 — Hemorrhage from other sites in respiratory passages is for bleeding not related to tracheostomyT81.31XA — Disruption of wound of other part of respiratory system with hemorrhage is for non-tracheostomy surgical wound bleeding