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| ''For other types of diagnoses, see [[Admit Diagnosis]] and [[Comorbid Diagnosis]].'' | | ''For other types of diagnoses, see [[Admit Diagnosis]] and [[Comorbid Diagnosis]].'' |
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| '''Acquired Diagnoses''', also referred to as '''complications''', are ''the most significant'' problems, surgical procedures or diagnostic procedures that happen to a patient '''AFTER''' unit admission. | | *'''Acquired Diagnoses''', also referred to as '''complications''', are problems or procedures that occur '''AFTER''' a patient has been '''accepted''' to a physician service ICU or Medicine regardless of physical location and has an [[Service tmp entry]] dttm. (While in ER collection starts at Accept DtTm). |
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| Acquired diagnoses are coded "in order of occurrence" on a ward/unit. | | An [[Acquired Diagnosis]] / Complication is coded by setting the [[Dx_Type]] to "acquired". |
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| Acquired diagnoses do '''not''' refer to diagnoses that have been '''discovered''' after the patient comes to the unit if it is likely that the patient was admitted to ward with the problem in the first place but it took a few days to figure that out. | | *Acquired diagnoses are prioritized ([[Dx Priority]] field) '''in order of occurrence.''' |
| | *Coding for Acquireds/complications follows the general [[ICD10 collection]] instructions. |
| | *'''The [[Dx_Date]] is mandatory for Acquireds/complications. ''' |
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| ==[[Significant complications medicine]]==
| | {{ICD10 Guideline Admit vs Acquired}} |
| For a list of the complications that are a '''priority''' which are looking for go to: [[Significant complications medicine]]
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| We don't repeat the diagnosis in the acquired section.For example if the admit diagnosis is CHF they get treated but relapse back into CHF we do not add that as a acqiured complication.
| | == Repeating Complications == |
| | *In general things that occur, fully resolve, and then recur SHOULD be coded each time they recur. |
| | **e.g. postop hemorrhage --> goes to OR to have it fixed --> IS fixed ---> 3 days later has more postop hemorrhage |
| | *For things that happen multiple times, some we WANT to list multiply and others we only list once |
| | **The ones we only list once include that info: [[Template:ICD10 Guideline repeated events]]. These are generally signs/symptoms, and arrythmias. |
| | **Otherwise, DO list it multiply --- e.g. after admit has a stroke --> 4 days later has a NEW/DIFFERENT stroke. |
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| For procedures we can repeat them once as a complication. For example if the patient came in with a scope in the admit and then had 3 more scopes in the hospital you would enter it''' once''' as an acquired.Another example skin grafting enter it once.
| | ==Data Structure== |
| | Acquired Diagnoses are drawn from [[S_ICD10 table]] and stored in [[L_ICD10 table]]. |
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| ==[[Significant complications ICU]]== | | == Cross checks == |
| For a list of the complications that are a '''priority''' which we are looking for go to:[[Significant complications ICU]]
| | * [[Query check ICD10 date]] |
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| == Maximum Number of Acquired Diagnoses == | | ===Related articles === |
| The PDA and the CCMDB.mdb can record as many acquired diagnoses as you want as you go along. However, only the '''nine (9)''' with the highest priority will be appended to [[TMSX]].
| | {{Related Articles}} |
| Since acquired diagnoses are prioritized by order of occurrence, this means that you might want to re-prioritize or delete more minor acquireds if keeping them would mean that a more major acquired diagnosis would not be within the 9 highest priorities, and therefore would not be sent. See [[Significant complications medicine]] & [[Significant complications ICU]] to guide you in this judgement.
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| == loosing info for long-term patients==
| | [[Category:ICD10]] |
| {{discussion}}
| | [[Category:Data Collection Guide]] |
| *As our ICU's have more and more [[LTV]] patients that are essentially a hospital hold for IICU, Riverview etc this section will have to be re-vamped...ex: I have a pt that will soon have been in the ICU for a year. We are losing points and information about this patient as we are only counted for the top "9" with the highest priority. In my case I am deleteing numerous high priority complications because of this...so in the end... what is collected is not indicative of that patient at all????--[[User:Wturner|Wturner]] 13:15, 7 February 2010 (CST)
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| ** Trish, I think the way I cleaned up the main section of this article means that the max # of points possible will be collected. This would mean that Wendy's concern is addressed, correct? If you agree, please remove this section. [[User:Ttenbergen|Ttenbergen]] 16:58, 2 November 2010 (CDT)
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| ***I don't know what you mean by point for complications?--[[User:TOstryzniuk|TOstryzniuk]] 17:32, 3 November 2010 (CDT)
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| **** I meant that, with the changes I had made to the instructions, the most important complications would be the ones that would stay. Specifically, that as you run out of spots you delete the ones that are not as important so that we get the most importand complications within the limited number of spots available, rather than the original instructions to be entirely chronological. This still isn't a good way to do this; one way to fix would be to wait for the new repository with unlimited # of complications, another would be to add a column to prioritize s_alldxs into groups of prioirties for the dx (vs priorities for the ''collected'' dx), so that I could sort the list first by priority and then chronologically (would not work if we use the fact that the list is currently chronological for anything). This is a bit of a messy explanation, call if you want to talk about it.[[User:Ttenbergen|Ttenbergen]] 09:56, 4 November 2010 (CDT)
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| == should it be "acquired diagnoses" or "complications"? ==
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| {{discussion}}
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| right now different terms are used in different places. EG CCMDB uses acquired, this article is acquired, I don't know what TMSX uses, but the category name is "complications". Can we settle on one? I am volunteering to clean this up on the wiki if we settle on one. [[User:Ttenbergen|Ttenbergen]] 16:58, 2 November 2010 (CDT)
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| **both terms are used to refer to problems, procedures, surgery that occur "AFTER" the patient is admitted to a unit.--[[User:TOstryzniuk|TOstryzniuk]] 17:31, 3 November 2010 (CDT)
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| ===Data Structure===
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| Acquired Diagnoses are drawn from [[S_AllDiagnoses]] and stored in [[L_Dxs]] on the PDA and in the [[CCMDB.mdb]].
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| [[Category: Complications | * ]] | |
| [[Category: Diagnosis Coding | *]]
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| [[Category: Data Collection Guide]] | |
| [[Category: Questions_Diagnosis]]
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