Overstay Predictor Diagnosis Code Used

List of diagnosis codes used for the algorithm for the Medicine Program Overstay Predictor Project

• Dr. Dan Roberts wants the following: any “admit” or “acquired complication” diagnosis codes that we have in our code book that are NEWLY occurring neurologic insults that would almost invariably lead to a “permanent” severe physical disability AND/OR cognitive disability AND therefore will most likely cause a delay in discharge.

• Pre-existing underlying neurological conditions ( comorbid conditions) such as; old strokes, previous brain bleeds, ALS, MS, Cerebral Palsy, Myasthenia Gravis, brain or spinal tumors, spinal compressions due to tumors or degenerative disease, meningitis, anoxic, metabolic, hepatic, toxic encephalopathy, neurotoxic drugs etc…., are NOT included in the algorithm. Though all other types of neurological problems could “potentially” cause neurological impairment and lead to discharge delays, for the purpose of this algorithm Roberts only needs to capture “NEW SEVERE neurological events” that have the highest likelihood of causing severe permanent dysfunction.

• so will these no longer be coded in comorbids? Stephanie
  • you will still continue to code comorbid conditions the same way as you do now. The list of admit and acquired complications is only for the the predictor algorithm. Trish Ostryzniuk 14:29, 2012 June 12 (CDT)

The list of diagnosis to be included from admit or acquired/complication are: The overstay project uses a number of diagnoses as indicators whether a patient would be likely to overstay due to difficulty in discharging. The following diagnoses are included to accomplish this.

• 502 ICH
• 503 SAH
• 504 Brain Stem Hemorrhage
• 505-0 CVA
• 505-1 CVA post angio
• 505-2 CVA post op
• 505-3 CVA post trauma
• 505-4 CVA post anticoagulation therapy
• 505-5 CVA intra-op
• 505-6 CVA post partum
• 505-7 CVA super sagittal sinus
• 505-8 CVA brainstem
• 505-90 CVA 2nd to other PROCEDURES
• 506 Tentorial_Herniation
• 529 Post Traumatic Quadriplegia
• 537 Paraplegia, Hemiplegia due to any condition
• 599-4 Cerebral Infarct Cause NYD
• 599-5 Quadraparesis-Post OP
• 599-6 Traumatic Paralysis 2nd to Spinal Subdural Bleed
• 599-18 Spinal Cord Infarct
• 603 SAH - Subarachnoid - POST OP
• 604 SAH Subarachnoid-NON POST OP
• 609 C-spine trauma WITH cord injury
• 611 T-spine WITH cord injury
• 613 L-spine WITH cord injury
• 648 Brainstem Hemorrhage-NON POST OP craniotomy
• 695 Diffuse axonal injury (likely be in an ICU not med ward)
• 983 CVA (stroke) due to central line insertion

Other diagnoses that might cause overstay

The overstay team is aware that some other diagnoses might also cause discharge delays. If you come across some that we missed, please add them below, with a reason why they should be included. We will review the algorithm over time and might decide to include these at that time.

• e.g. diagnosis
  • e.g. reason to include