Significant complications

Significant complications tracked on medicine units.--TOstryzniuk 20:35, 24 November 2009 (CST)

• Complication/acquired DX code:

1. Central Line complication (requires transfusion or surgery)

• • 86000 - Central Line related infections (subcode 1-95 - not all subcodes apply and we have no rules to exclude any)
  • 98003 – Pneumothorax – 2nd to central line insertion
  • 98102 – Hemothorax – 2nd to central line insertion
  • 98201 - Significant bleed - 2nd to central line - Femoral Artery/vein
  • 98203 - Significant bleed - 2nd to central line - Pulmonary Artery
  • 98203 - Significant bleed - 2nd to central line - subclavian arter/vein
  • 98205 – Significant bleed - tamponade 2nd to central line

• • 98300 Stroke due to central line
  • 98500 Ischemia 2nd to central line (swan ganz, IJ, Subclavian)
  • 98900 Loss or broken guidewire with central line insertion
  • 99000 Arterial insertion of venous central line (malpositioning of PA or IJ into carotid artery or LV).

2. DVT -do you just want just lower extremity DVT or any other type?

• • 13200 (code by itself is mixed bag of Arterial or venous embolus or Thrombus)
  • 13201 Femoral (lower extremity)
  • 13202 Popiteal (lower extremity)
  • 13203 Subclavian (upper extremity/thorax-armpit, collar bone area)
  • 13204 Superior mesenteric (abdomin)
  • 13205 Post Operative (anywhere in body)
  • 13206 Internal Jugular (upper extremity/thorax –neck area)
  • 13208 Axillary (upper extremity/thorax-armpit - collar bone area)
  • 13209 Innominate (upper extremity/thorax -)

• • • 13606 aortic – Excluded because this is generally a paradoxical embolization of DVT thrombus into the aorta. Our code is a mixed bag of arterial venous embolus or thrombus so don’t include for DVT.

3. Hospital Acquired Decubitus Ulcer

• • 94500 Decubitus Ulcers only (used without subcode if stage unknown)
  • 94501 – stage 1 surface reddening
  • 94502 – just under skin
  • 94503 – deep to muscle
  • 94504 –full layer to bone

4. Hospital Acquired Pneumonia

• • 3800 – subcodes 1-95 (exclude subcode 59, see below)
  • 3600 – subcode 1-95 (Pneumonia if not sure if hosp or community acquired, exclude subcode 59).

5. Aspiration Pneumonia

• • 3859 - hospital acquired aspiration pneumonia

6. Pulmonary Embolus

• • 1300 Pulmonary Embolus (used without subcode if reason is unknown)
  • 1301 Pulmonary Embolus- Septic
  • 1302 Thrombic
  • 1303 Post Operative
  • 1304 Air
  • 1305 Post Trauma-fat emboli – not included for medicine
  • 1390 other reason (same as using 1300 when reason is unknown)

7. Cardiac arrest

• • 10001 unwitnessed cardiac arres
  • 10002 witnessed cardiac arrest

8. CVA - Cerebral Vascular Accident

• • 50501 Post angiogram CVA
  • 50502 Post operative procedure
  • 50504 Post anticoagulation therapy
  • 50505 Intra-operative procedure CVA
  • 50506 Post Partum CVA
  • 50590 2nd to Other medical procedure
  • 98300 Stroke due to central line (also see Central line complications)

9. Nasogastric tube placement problems

• • 99101 Aspiration due to Malpositioning

10. Septic shock

• • 4400 (subcode 1-95)

11. Severe Sepsis

• • 4500 (subcodes 1-95)

12. Septecimia

• • 4600 (subcode 1-95)

13. Cystitis

• • 5100

14. Esophagitis 2nd to infection

• • 6400 (subcode 1-95)

15. Gastroenteritis

• • 6500 (subcode 1-95)

16. Neutropenic entercolitis

• • 6800 (subcode 1-95)

17. Pseudomembranous colitis - C-diff

• • 7212

18. post op surgical wound infection

• • 8300 (subcode 1-95)

19. soft tissue abcess

• • 8400 (subcode 1-95)

20. Soft tissue infection (includes cellulitis)

• • 8500 (subcode 1-95)

21. other ulcers

• • 94700

22. Tracheostomy (complications)

• • 77404 obstruction
  • 77405 malpositioning
  • 77406 bleeding (significant)
  • 77407 Fistula formation
  • 77408 site infection
  • 77490 any other complications

23. Pneumothorax (2nd to procedures)

• • 98001 2nd to pleural tap/thoracentesis
  • 98002 2nd to chest tube insertion
  • 98003 (see item #1 above - central line complication)
  • 98090 2nd to other procedures

24. Hemothorax (2nd to procedures)

• • 98101 2nd to pleural tap/thoracentesis
  • 98102 (see #1 above - central line complication)
  • 98103 2nd to chest tube insertion
  • 98190 2nd to other procedures

25. Main stem intubation

• • 98600

26. Aortic dissection post angioplasty

• • 98700

27. Liver laceration 2nd to chest tube insertion or other procedure

• • 98900

Dan had provided a specific list of complication he wanted to track for medicine wards. Trish to add others here when she has time.--TOstryzniuk 20:48, 23 November 2009 (CST)