Primary Admit Diagnosis

The Primary Admit Dx (Most Responsible Diagnosis, MRDx) is the dx most responsible for an admission to that unit/ward. See Dx Primary for details on how it is collected.

• When there are multiple competing diagnosis choose the diagnosis that is the most severe or responsible for the admission. At times this may be difficult to determine, use your best clinical judgment based on the documentation.
• If multiple trauma is part of the admit diagnosis, then among this group of linked ICD10 codes, the Primary Admit Diagnosis would be either the Multiple trauma or the "worst" thing injured, e.g. Brain injury, diffuse (TBI), injury/trauma

Allan could you please provide some clarification on post op cardiac surgery patients? In the past (although I cannot find a reference on the wiki) we were instructed to mark the primary as the reason for the procedure or long ago (before CCI) the surgery itself. This somehow does not feel correct. for example a post op CABG comes out on pressors, with a pa catheter and reduced CO/CI and is in cardiogenic shock, we use the Iatrogenic, hypotension/shock, postoperative/post-procedural and also code Shock, cardiogenic and link it with Coronary artery disease, chronic and Angina pectoris, stable or NOS or Angina pectoris, unstable It seems to me that the primary should be the cardiogenic shock? but if the same patient comes out on pressors for a few hours, I would use the Iatrogenic, hypotension/shock, postoperative/post-procedural but would not necessarily code it as primary? IF the same patient comes out with no pressors, I would check the primary as the angina or CAD . I think some of the confusion comes from the fact that all CABG patients and post op valves are admitted to ICCS/ccu and some are quite stable, while other are not, but we need a rule so we code this consistently Lisa Kaita 11:38, 24 December 2025 (CST) I moved this from the Dx Primary page which explains how to collect this to this page. It was split out long ago since it combines a few different concepts. Documentation about how to decide what this is should live on this page. Ttenbergen 13:25, 24 December 2025 (CST)

• SMW

• Cargo

• Categories

Example:

Admitted with: Pneumonia, NOS which is noted to be not severe, and CVA which is severe Primary Reason to be checked off: CVA.

Data use

The concept is used by the following indicators:

• ICU Primary Diagnosis ICD10 Chapter Rate
• ICU Diagnosis APACHE Category Rate
• Medicine Primary Diagnosis Rate

Cross checks

See Dx Primary#Data Integrity Checks (SMW)

Related queries

• Query L_Dxs_w_primary
• Query L_ICD10_primary

Legacy info

Legacy info

Old dx schema Admit Diagnosis with highest priority