Dx Primary: Difference between revisions

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|created_raw=Raw
|created_raw=Raw
|data_element_sort_index=8
|data_element_sort_index=8
|element_description=True for the [[Admit Diagnosis]] that is the [[Primary Admit Diagnosis]]
|element_description=Checkbox that is set to true for a single [[Admit Diagnosis]] per ward stay that is the [[Primary Admit Diagnosis]]
}}
}}
The Dx primary is coded as part of the [[ICD10 collection]].  
The Dx primary is coded as part of the [[ICD10 collection]].  


It is used to designate the [[Admit Diagnosis]] that is the '''[[Primary Admit Diagnosis]]'''.
{{Ex | Admitted with: Pneumonia, NOS which is noted to be not severe, and CVA which is severe   
 
**Primary Reason to be checked off:  CVA.  }}
*Example:  Admitted with: Pneumonia, NOS which is noted to be not severe, and CVA which is severe, ATN.  
**Primary Reason to be checked off:  CVA.   
{{DiscussTask | For reporting purposes, Julie puts the primary diagnosis into  8 different categories:  respiratory disorders; post cardiac arrest; trauma and poisoning; metabolic/renal/GI/hypovolemic shock; cardiac disease; neurologic disorder; post-operative care; sepsis/septic shock.  Traditionally we have put the "primary" diagnosis as the main reason they are in the ICU (or ward).  The problem is that the reason they came may not really fit the proper category in all cases.  For example, the patient came to the ICU with respiratory failure requiring intubation, however the patient may have sepsis which caused the respiratory failure and technically we should be putting sepsis as our primary.  Another example is cardiac arrest which traditionally has always been put as the primary diagnosis.  However, it does not always capture the correct category which is why they went into cardiac arrest. They may have had an overdose or an airway obstruction or apnea or sepis or it may be a true cardiac event. We would put the cause still as #1 along with the cardiac arrest but it would be missed because Julie only picks up the primary (checked) diagnosis.  Putting cardiac arrest as primary can miss the true category.  To make it even more complicated however, there is a category for cardiac arrest so which is more important to capture?  We all need direction on which diagnosis is "primary". --[[User:LKolesar|LKolesar]] 13:38, 2019 June 25 (CDT)}}


== Collection Instructions ==
== Collection Instructions ==
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The diagnosis with this '''check mark''' should be one of those with the lowest [[Dx Priority]] used for an [[Admit Diagnosis]].
The diagnosis with this '''check mark''' should be one of those with the lowest [[Dx Priority]] used for an [[Admit Diagnosis]].
== Background ==
{{DiscussTask | For reporting purposes, Julie puts the primary diagnosis into 8 different categories: 
* respiratory disorders
* post cardiac arrest
* trauma and poisoning
* metabolic/renal/GI/hypovolemic shock
* cardiac disease
* neurologic disorder
* post-operative care
* sepsis/septic shock
Traditionally we have put the "primary" diagnosis as the main reason they are in the ICU (or ward).  The problem is that the reason they came may not really fit the proper category in all cases.  For example, the patient came to the ICU with respiratory failure requiring intubation, however the patient may have sepsis which caused the respiratory failure and technically we should be putting sepsis as our primary.  Another example is cardiac arrest which traditionally has always been put as the primary diagnosis.  However, it does not always capture the correct category which is why they went into cardiac arrest. They may have had an overdose or an airway obstruction or apnea or sepis or it may be a true cardiac event. We would put the cause still as #1 along with the cardiac arrest but it would be missed because Julie only picks up the primary (checked) diagnosis.  Putting cardiac arrest as primary can miss the true category.  To make it even more complicated however, there is a category for cardiac arrest so which is more important to capture?  We all need direction on which diagnosis is "primary". --[[User:LKolesar|LKolesar]] 13:38, 2019 June 25 (CDT)
** I guess the question is if any dxs can not be captured in those 8 groups. If they are all captured there is no problem, or is there? Ttenbergen 10:09, 2019 October 4 (CDT)}}


{{Data Integrity Check List}}
{{Data Integrity Check List}}