When to code a patient as post-op: Difference between revisions

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From an email from May 2007:
{{LegacyContent
|explanation=no longer relevant in [[CCI]]
|successor=[[CCI Collection]]
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'''Question: (from HSC data colelctors)'''
At the ''task meeting April 10,2014'' we discussed the coding of [[:Category:Surgical Procedure (old) | post-op]] patients who come from other locations than the OR or PACU.
"If a patient comes to medicine after having say a pace maker or some other surgical procedure how many days post-op do you put the procedure in your admit diagnosis"


'''Answer: (from an email from Trish)'''
The question was:
When do we include the surgical procedure as part of our diagnosis?
*The decision was made that a specific time frame for including the surgery was not the best way.
*If the recent surgery is '''relevant''' to reason for admission then include it in your admit dx as the last code.
*For example a patient had a hip replacement 10 days ago,develops a HAP and is admitted to your unit.The surgery could go in the last diagnostic spot.
*If reason for admission to your ward has nothing to do with recent surgery they don't include it in your diagnosis
*for coding instructions for angiograms see [[Coronary Angiogram]]
Dr Garland feels that collectors judgement is best on when to include the surgery in the diagnosis.


"If the recent surgery is relevant to reason for admission then include it in your admit dx as the last code.
== Related articles ==
{{Related Articles}}


If reason for admission to your ward has nothing to do with recent surgery they don't include.
[[Category:Surgical Procedure (old)| *]]
 
[[Category:Diagnosis Coding (old)]]
 
}}
Within 3-4 days is good enough"
 
 
{{discussion}}
== Discussion ==
* If a date is to be used as a cut-off, it should be a distinct date rather than a range. Which should it be? [[User:Ttenbergen|Ttenbergen]] 16:39, 16 May 2008 (CDT)
 
* The statement to only include it if relevant doesn't seem to require a date at all. Should a date even be part of the guideline? [[User:Ttenbergen|Ttenbergen]] 16:39, 16 May 2008 (CDT)
 
**Does this include angiograms?  When a pt has an angiogram/plasty/stent just prior to(reason for admisssion) or during their admission to ICU, should the procedure(s) be included in their admit Dx upon transfer to Medicine? ...If the angio should be coded as an admit to Medicine does this apply only if angio done less than 4 days prior to transfer to ward?[[User:Mlaporte|Mlaporte]] 18:28, 21 December 2010 (CST)
*** At HSC it is our understanding that Angiogram/Plasty/Stent is treated as a test,If a pt comes into our ER and has an urgent angio prior to coming to the unit, we would put it in our last admit. When pt is on the unit and has an angio it would be my complication, and when we transfer the pt to another unit it would not be recoded. On my unit B3 because it is split into medicine/day surgery I will get day surgery pts that went for dx angio and come back as plasties and would have to be admitted for monitoring, they are admitted as medicine pts and their 1st admit would be the angio/plasty/stent and then what ever(most likely USA)--[[User:PStein|PStein]] 11:25, 22 December 2010 (CST)
 
== to do before de-stubbing ==
- once the discussion concludes this should be pulled into collection guidelines framework
 
*I had a pt who had an ORIF done and was transfered to MICU in cardiogenic shock 2 days post op.  3 days post op she has a CVA.  Do I subcode the CVA as postop?[[User:MWaschuk|MWaschuk]] 14:22, 17 June 2008 (CDT)
 
 
{{stub}}
[[Category:Questions]]
[[Category:Diagnosis Coding]]
[[Category:Questions General Collection]]

Latest revision as of 11:11, 30 July 2025

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At the task meeting April 10,2014 we discussed the coding of post-op patients who come from other locations than the OR or PACU.

The question was: When do we include the surgical procedure as part of our diagnosis?

  • The decision was made that a specific time frame for including the surgery was not the best way.
  • If the recent surgery is relevant to reason for admission then include it in your admit dx as the last code.
  • For example a patient had a hip replacement 10 days ago,develops a HAP and is admitted to your unit.The surgery could go in the last diagnostic spot.
  • If reason for admission to your ward has nothing to do with recent surgery they don't include it in your diagnosis
  • for coding instructions for angiograms see Coronary Angiogram

Dr Garland feels that collectors judgement is best on when to include the surgery in the diagnosis.

Related articles

Related articles:
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