Admit Procedure: Difference between revisions

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*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

**(b) Was '''causally''' related to the admission -- this is a judgement call, see section and examples below

{{Discuss | who = Allan | question = For CXR's and blood gases which we are counting only the acquired numbers, do we need to include these in the Admit Procedures? Allan clarified this and we do not include any procedures in the admit category unless they cause the diagnosis in some way. My question is : some CCI list things may need to be put in the admit category, even if not causal: one example of this is [[Isolation, infectious]]. Putting this in the admit category would mean the pt had it on admission, whereas, if acquired during their stay, then we put it in the acquired category. The instructions need to be clarified to take this into account.--[[User:LKolesar|LKolesar]] 10:45, 2018 September 7 (CDT)}}

=== 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.

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

*VERY IMPORANT DISTICTION: A procedure that simply '''identified''' the presence of a problem should not be considered to have ''caused'' the problem, and so should not be put into this category.

*While causally-related procedures will ''usually'' be invasive procedures, they do not NEED to be -- e.g. if a person is admitted for expressly [[Isolation, infectious]], this could be in this bin.

*And on occasion, even a diagnostic procedure could be causative --- e.g. a contrast-enhanced X-ray where the contrast caused anaphylaxis that led to ICU admission. But this kind of example is the only kind of situation in which a non-invasive diagnostic procedure should be in this bin. So, things we count, such as CXRs and blood gases, would NOT be in this bin, unless somehow they actually caused a problem that led to admission (e.g. blood gas puncture injured the artery, leading to a huge bleed for which they went to ICU).

{{Collapsable

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| 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.

}}

{{Discuss | who = Allan | question = 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)}}

=== Moved patients ===

@@ Line 4: / Line 4: @@
 *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
+**(b) Was '''causally''' related to the admission -- this is a judgement call, see section and examples below
-{{Discuss | who = Allan | question =  For CXR's and blood gases which we are counting only the acquired numbers, do we need to include these in the Admit Procedures? Allan clarified this and we do not include any procedures in the admit category unless they cause the diagnosis in some way.  My question is : some CCI list things may need to be put in the admit category, even if not causal:  one example of this is [[Isolation, infectious]].  Putting this in the admit category would mean the pt had it on admission, whereas, if acquired during their stay, then we put it in the acquired category.  The instructions need to be clarified to take this into account.--[[User:LKolesar|LKolesar]] 10:45, 2018 September 7 (CDT)}}
 === 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.
+*It won't always be so clear if a procedure is related to the admission, and you may have to use your judgement.
+*VERY IMPORANT DISTICTION:  A procedure that simply '''identified''' the presence of a problem should not be considered to have ''caused'' the problem, and so should not be put into this category.
+*While causally-related procedures will ''usually'' be invasive procedures, they do not NEED to be -- e.g. if a person is admitted for expressly [[Isolation, infectious]], this could be in this bin.
+*And on occasion, even a diagnostic procedure could be causative --- e.g. a contrast-enhanced X-ray where the contrast caused anaphylaxis that led to ICU admission.  But this kind of example is the only kind of situation in which a non-invasive diagnostic procedure should be in this bin.  So, things we count, such as CXRs and blood gases, would NOT be in this bin, unless somehow they actually caused a problem that led to admission (e.g. blood gas puncture injured the artery, leading to a huge bleed for which they went to ICU).
 {{Collapsable
@@ Line 22: / Line 24: @@
 | 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.
 }}
-{{Discuss | who = Allan | question = 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)}}
 === Moved patients ===