This page explains when a CCI Procedure that is part of CCI Collection would be coded with Px Type Acquired. The instructions are the same for medicine an critical care. The other option for type is Admit Procedure.
A procedure should be coded as Px Typeacquired if it occurs after the start of the database record (i.e. when the patient's care has been taken over by the admitting service, ie after Accept DtTm) and before the patient is discharged (ie before Dispo DtTm).
Even if the procedure was planned before the service took over their care, but wasn't performed until after, then Px Type is acquired.
As of October 2020, a single record may span direct transfers between different locations and even between different services. Accordingly, an admit procedure only relates to the very start of that database record. Procedures that do not qualify as an admit procedure will be acquired.
Example: Admitted to MICU for sepsis --> 2 days later develops an acute abdomen and goes to OR where gets a bowel resection --> goes to PACU --> goes to SICU service and SICU as location. Since the ADMISSION of this continuous episode of ICU care (i.e. MICU-->SICU) was to MICU, and we do not begin a new record with the switch to SICU, this bowel resection is an acquired procedure, not an admit procedure
example of pre-planned procedure
Patient admitted via ED with an acute abdomen. Plan was to take the patient to the OR for exploratory lap, but the OR wasn't ready yet. So patient went to the ICU first, and within 30 minutes of getting there, THEN went to the OR. This procedure was then acquired.