Admit Procedure: Difference between revisions

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== Collection Instructions ==
== Collection Instructions ==
*Code a procedure as '''admit''' if it was:   
*Code a procedure as [[Px_Type]] '''admit''' if it was:   
**(a) Performed '''within 24 hrs''' BEFORE the [[Arrive DtTm]] '''AND'''  
**(a) Performed '''within 24 hrs''' BEFORE the [[Arrive DtTm]] '''AND'''  
**(b) Was '''causally''' related to the admission -- this is a judgement call, see the examples below
**(b) Was '''causally''' related to the admission -- this is a judgement call, see the examples below


=== Causally related ===
It won't always be so clear if a procedure is related to the admission, and you may have to use your judgement.


{{Collapsable  
{{Collapsable  
| always= example of causally related procedures  
| always= example of causally related procedures  
| full=  
| full= * 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'''.
*Even diagnostic procedures can be causally related to an admission, if a complication occurred:
** a contrast CT that led to contrast-induced anaphylaxis that was the reason for admission
** a diagnostic upper endoscopy that caused an esophageal perforation that was the reason for admission.
}}
}}


{{Collapsable  
{{Collapsable  
| always= example of procedures not causally related
| always= example of procedure not causally related
| full=  
| full= *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 acute ''To'' 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.
}}
}}


**If a patient goes to ward/unit immediately after surgical procedure (possibly with a stop in PACU) then code Px_Type = Admit
{{DiscussAllan | One might think of a diagnostic procedure as "causing" an admission by helping confirm a diagnosis, i.e. the px doesn't cause the patient to need admission, but it causes the physician to know the patient needs admission. Should those be coded as admit px then? Ttenbergen 19:47, 2018 August 6 (CDT)}}
**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.
 
**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'''
=== Moved patients ===
**Even diagnostic procedures can be causally related to an admission, if a complication occurred.  Examples might include: (a) a contrast CT that led to contrast-induced anaphylaxis that was the reason for admission, or (b) a diagnostic upper endoscopy that caused an esophageal perforation that was the reason for admission.
A procedure might be coded as an acquired on one ward and an admit on the next - the same as above applies.


*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.
{{Collapsable  
{{Collapsable  
| always=example of procedures for moved patient
| always=example of procedures for moved patient
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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.}}
*'''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.}}


*It won't always be so clear if a procedure is related to the admission, and you may have to use your judgement.
== Why within 24 hrs? ==
 
==== Why within 24 hrs? ====
This was an arbitrary decision because we needed a cut-off.
This was an arbitrary decision because we needed a cut-off.


 
== Related Articles ==
{{Related Articles}}




[[Category: CCI]]
[[Category: CCI]]

Revision as of 18:47, 6 August 2018

This page explains when a CCI Procedure that is part of CCI Collection would be coded with Px Type Admit. The other option for type is Acquired Procedure.

Collection Instructions

  • Code a procedure as Px_Type admit if it was:
    • (a) Performed within 24 hrs BEFORE the Arrive DtTm AND
    • (b) Was causally related to the admission -- this is a judgement call, see the examples below

Causally related

It won't always be so clear if a procedure is related to the admission, and you may have to use your judgement.

example of causally related procedures   
  • 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.
  • Even diagnostic procedures can be causally related to an admission, if a complication occurred:
    • a contrast CT that led to contrast-induced anaphylaxis that was the reason for admission
    • a diagnostic upper endoscopy that caused an esophageal perforation that was the reason for admission.
example of procedure not causally related   
  • 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 acute To 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.

Template:DiscussAllan

Moved patients

A procedure might be coded as an acquired on one ward and an admit on the next - the same as above applies.

example of procedures for moved patient   
  • 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.
  • 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.

Why within 24 hrs?

This was an arbitrary decision because we needed a cut-off.

Related Articles

Related articles:
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