When to code a patient as post-op
From an email from May 2007:
Question: (from HSC data colelctors)
"If a patient comes to medicine after having say a pace maker or some other surgical procedure how many days post-op do you put the procedure in your admit diagnosis"
Answer: (from an email from Trish)
"If the recent surgery is relevant to reason for admission then include it in your admit dx as the last code.
If reason for admission to your ward has nothing to do with recent surgery they don't include.
Within 3-4 days is good enough"
Discussion
- If a date is to be used as a cut-off, it should be a distinct date rather than a range. Which should it be? Ttenbergen 16:39, 16 May 2008 (CDT)
- The statement to only include it if relevant doesn't seem to require a date at all. Should a date even be part of the guideline? Ttenbergen 16:39, 16 May 2008 (CDT)
- Does this include angiograms? When a pt has an angiogram/plasty/stent just prior to(reason for admisssion) or during their admission to ICU, should the procedure(s) be included in their admit Dx upon transfer to Medicine? ...If the angio should be coded as an admit to Medicine does this apply only if angio done less than 4 days prior to transfer to ward?Mlaporte 18:28, 21 December 2010 (CST)
- At HSC it is our understanding that Angiogram/Plasty/Stent is treated as a test,If a pt comes into our ER and has an urgent angio prior to coming to the unit, we would put it in our last admit. When pt is on the unit and has an angio it would be my complication, and when we transfer the pt to another unit it would not be recoded. On my unit B3 because it is split into medicine/day surgery I will get day surgery pts that went for dx angio and come back as plasties and would have to be admitted for monitoring, they are admitted as medicine pts and their 1st admit would be the angio/plasty/stent and then what ever(most likely USA)--PStein 11:25, 22 December 2010 (CST)
- Does this include angiograms? When a pt has an angiogram/plasty/stent just prior to(reason for admisssion) or during their admission to ICU, should the procedure(s) be included in their admit Dx upon transfer to Medicine? ...If the angio should be coded as an admit to Medicine does this apply only if angio done less than 4 days prior to transfer to ward?Mlaporte 18:28, 21 December 2010 (CST)
- The following are the guidelines for coding Angiograms (as discussed with Trish):
-When a patient goes for an angiogram and is then admitted to ICU the Angiogram is part of the ICU Admit Diagnosis.
-When a patient admitted in an ICU goes for an angiogram and returns to the same ICU the Angiogram is an ICU Acquired Complication.
-When either of the above patients are transferred to the Medical ward DO NOT code the angiogram as part of the Medicine Admit Diagnosis. The data between continuous ICU and Medicine admissions can be linked; so there is no need to code the angiogram twice.
--When a patient admitted in an ICU goes for an angiogram and does not return to ICU; but, goes directly to a Medicine ward post-angio the Angiogram is a part of the Medicine Admit Diagnosis.Mlaporte 18:24, 18 January 2011 (CST)
to do before de-stubbing
- once the discussion concludes this should be pulled into collection guidelines framework
- I had a pt who had an ORIF done and was transfered to MICU in cardiogenic shock 2 days post op. 3 days post op she has a CVA. Do I subcode the CVA as postop?MWaschuk 14:22, 17 June 2008 (CDT)