Admit Procedure

This page explains when a CCI Procedure that is part of CCI Collection would be coded with Px Type Admit. The other option for type is Acquired Procedure.

Collection Instructions

• Code a procedure as admit if it was:
  • (a) Performed within 24 hrs BEFORE the Arrive DtTm AND
  • (b) Was causally related to the admission -- this is a judgement call, see the examples below

example of causally related procedures

example of procedures not causally related

• • If a patient goes to ward/unit immediately after surgical procedure (possibly with a stop in PACU) then code Px_Type = Admit
  • If a patient on the From ward/unit gets a bedside debridement which went well, and 10 minutes later develops respiratory distress and goes to a more To acute ward/unit because of that respiratory distress, then do not code that debridement at all for the To acute ward/unit because it does not seem to be related to the admission to the To ward/unit.
  • On the other hand, if a patient on the From ward/unit gets a bedside debridement, during which he/she begins to hemorrhage profusely and is then transferred to the To acute ward/unit because of that hemorrhage, then code that procedure, as Px_Type = Admit
  • Even diagnostic procedures can be causally related to an admission, if a complication occurred. Examples might include: (a) a contrast CT that led to contrast-induced anaphylaxis that was the reason for admission, or (b) a diagnostic upper endoscopy that caused an esophageal perforation that was the reason for admission.

• If a procedure was done in one of our collected locations (medicine or ICU) and then the patient was sent to another of our collected locations, use the same concept as above to decide whether to record that procedure in the 2nd location's record.

example of procedures for moved patient

Example: On Medicine ward patient got bedside debridement (so of course that procedure would be coded for that ward) and then began to hemorrhage which led to ICU transfer. In this case the debridement was closely associated with the admission to ICU and so would be coded as an "admit" procedure for the ICU record. Example: On the other hand, if the ward patient got a bedside skin biopsy shortly before transfer to ICU, and the ICU transfer had nothing to do with the skin biopsy, then you would NOT record the biopsy in the ICU record.

• It won't always be so clear if a procedure is related to the admission, and you may have to use your judgement.

Why within 24 hrs?

This was an arbitrary decision because we needed a cut-off.