Isolation, infectious

CCI Picklist
Procedure:	Isolation, infectious
CCI Picklist code:	7.SC.70.SA
CCI Collection Mode:	CCI collect first
Start Date:	2018-04-25
Stop Date:

This procedure is a part of CCI Collection via CCI Picklist.

Additional Info

• This is a procedure code for a patient who is on infection isolation precautions.
  • To qualify for this, the patient must himself/herself have a condition for which isolation is indicated. So, a group for which this code should NOT be used are patients who are put on isolation precautions PROPHYLACTICALLY, i.e. for infection present in somebody else on the ward. An example is when a group of ward patients get C. diff and in response everyone on that ward is put on isolation precautions. The patients on such prophylactic precautions would NOT get this code. However, if such a person then does get (in this example) C. diff, he/she would get this code as of the day he/she got the infection for which the isolation is being done.
• It includes any/all of the following kinds of isolation protocols:
  • gloves only
  • gloves and gown
  • mask
  • negative pressure room use
  • reverse isolation
  • cohorting the patient with other patients with the same pathogen

In the context of Colonized with organism (not infected)

• If a patient is placed on Isolation, infectious on arrival only for the reason of pre existing MRSA (or other colonization), then code Admit Diagnosis Colonized with organism (not infected) and code the isolation as an Admit Procedure.

• For patients who have MRSA in comorbs, and are admitted for other reasons, put Isolation, infectious in acquired CCI codes.

For patients who are admitted and have pre existing MRSA to code infectious isolation as an acquired CCI code is counterintuitive if it is present and treated with isolation on admission. Pre existing colonization would be included as an ADMIT DX if treated with isolation, and the isolation would be included as an admit CCI procedure. I agree, it does feel counterintuitive, but if we are following the WIKI guidelines, it seems like this is how we are supposed to code it. I think their is currently a lot of discrepancy in how this is being coded. there seems to be confusion all around when to code something as an admit vs acquired vs comorbid. One example we have seen, someone comes in to ICU with stab would injury to heart, has had cardiac arrests, and is in shock. We see the trauma injury to heart coded as comordid. Need to discuss collection instruction tweek that would help Allan recently updated Admit Procedure with info that is relevant to this. I wonder if the instructions on this page are just a remnant from an earlier iteration of the Admit instructions. As I read the current ones, you would not code this. But yes, good we are taking it to Task...

• SMW

• Cargo

• Categories

Isolation for Use of Cytotoxic Agents

• This is NOT included because such isolation (e.g. keeping pregnant nurses from caring for patients getting certain teratogenic medications) is not isolating the patient.

Collecting "CCI collect first" items

• "CCI collect first" items are entered the first time they happen
• Px Date
  • if an Acquired Procedure, enter them with the Px Date of the first time they happen
  • if an Admit Procedure leave the date blank and just enter the procedure
• Px Count is always 1 for this collection mode

Px Date for patients who move

See Px Date#Moves

Alternate CCIs to consider coding instead or in addition

ExpandOther procedure in Therapeutic Procedure:

Related ICD10 Codes

Data Integrity Checks (automatic list)

none found

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