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| {{Data element | | {{Data element |
| | | CCMDB_tab = CCI |
| |field_name=Px Type | | |field_name=Px Type |
| |CCMDB_label=Px Type | | |CCMDB_label=Px Type |
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| === Additional Info === | | === Additional Info === |
| *This item is a part of the recording of procedures in CCI. It is mandatory for every procedure coded. It has 2 possible values: '''admit''' versus '''acquired'''. | | *This item is a part of the recording of [[CCI Procedure]] that is part of [[CCI Collection]]. It is mandatory for every procedure coded. It has 2 possible values: |
| *It refers to whether the procedure occurred before and associated with the with the patients's admission to the unit OR was done after admission.
| | * admit - see '''[[Admit Procedure]]''' for details |
| | * aquired - see '''[[Acquired Procedure]]''' for details |
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| === Px Type = Admit === | | === Cross Checks === |
| *Code a procedure as '''admit''' if it was:
| | {{Data Integrity Check List}} |
| **(a) Performed '''within 24 hrs''' BEFORE the [[Arrive DtTm]] '''AND'''
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| **(b) Related to the admission.
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| *'''"Related to the admission"''' can be less clear.
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| **If a patient goes to ward/unit immediately after surgical procedure (possibly with a stop in PACU) then code Px_Type = Admit
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| **If a patient on the ''From'' ward/unit gets a bedside debridement which went well, and 10 minutes later develops respiratory distress and goes to a more ''To'' acute ward/unit because of that respiratory distress, then '''do not code that debridement at all''' for the ''To'' acute ward/unit because it does not seem to be related to the admission to the ''To'' ward/unit.
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| **On the other hand, if a patient on the ''From'' ward/unit gets a bedside debridement, during which he/she begins to hemorrhage profusely and is then transferred to the ''To'' acute ward/unit because of that hemorrhage, then '''code that procedure, as Px_Type = Admit'''
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| *If a procedure was done in one of our collected locations (medicine or ICU) and then the patient was sent to another of our collected locations, use the same concept as above to decide whether to record that procedure in the 2nd location's record.
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| **'''Example''': On Medicine ward patient got bedside debridement (so of course that procedure would be coded for that ward) and then began to hemorrhage which led to ICU transfer. In this case the debridement was closely associated with the admission to ICU and so would be coded as an "admit" procedure for the ICU record.
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| **'''Example''': On the other hand, if the ward patient got a bedside skin biopsy shortly before transfer to ICU, and the ICU transfer had nothing to do with the skin biopsy, then you would NOT record the biopsy in the ICU record.
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| *It won't always be so clear if a procedure is related to the admission, and you may have to use your judgement.
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| ==== Why within 24 hrs? ====
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| * The rationale for 24 hrs is as follows:
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| ** The purpose of Admit procedure coding is to identify procedures for which the patient came to the unit. If the procedure occurred and the patient went to the ward (for example) and then the next day had a complication of the procedure, then certainly code the diagnosis as [[Iatrogenic codes in ICD10 | iatrogenic code]] (related to the procedure) but that patient did not come to the ICU directly due to the procedure (i.e. postop).
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| {{DiscussAllan | That doesn't actually provide a reason for 24hrs specifically, it just reiterates it. Why did we want to restrict this by temporal factor rather than causation, and why 24 rather than 48 or 6? }}
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| === Px Type = Acquired ===
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| *This category is for procedures that occur after [[Arrive DtTm]] and before [[Dispo DtTm]].
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| *Even if the procedure was planned before admission, but wasn't performed until after, then '''[[Px Type]]''' is ''acquired''.
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| **Example: Patient admitted via ED with an acute abdomen. Plan was to take the patient to the OR for exploratory lap, but the OR wasn't ready yet. So patient went to the ICU first, and within 30 minutes of getting there, THEN went to the OR. This procedure was then '''acquired'''.
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| === CCMDB Data Integrity Checks ===
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| {{CCMDB Data Integrity Checks|ready to implement}} | |
| * date for procedure with [[Px Type]] admit has to have [[Px Date]] before [[Arrive DtTm]]
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| * date for procedure with [[Px Type]] acquired has to be after [[Arrive DtTm]] and before [[Dispo DtTm]]
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| === See Also ===
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| *[[Admit Diagnosis]]
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| *[[Acquired Diagnosis / Complication]]
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| ===Related articles === | | ===Related articles === |