For other types of diagnoses, see Admit Diagnosis and Comorbid Diagnosis.
- Acquired Diagnoses, also referred to as complications, are problems or procedures that occur AFTER a patient has been accepted to a physician service ICU or Medicine regardless of physical location and has an Service tmp entry dttm. (While in ER collection starts at Accept DtTm).
An Acquired Diagnosis / Complication is coded by setting the Dx_Type to "acquired".
- Acquired diagnoses are prioritized (Dx Priority field) in order of occurrence.
- Coding for Acquireds/complications follows the general ICD10 collection instructions.
- The Dx_Date is mandatory for Acquireds/complications.
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Como Admit Acquired Primary Limits - this is part of that discussion - if we limit which admits will count as comos we need to review
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Example:
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- Example1 -- patient's care is taken over by Medicine service while he is still in ED. The admission diagnosis is DKA. He remains on Medicine service in ED (due to lack of ward beds) for 2 days, after which he finally gets up to the Medicine ward and then has a stroke. The stroke is an Acquired Diagnosis, and would still be acquired even if it had occurred during those 2 days in ED.
- AND
- Dx is relevant to this admission in that it is either:
- (a) an acute or exacerbated condition (as opposed to a chronic, stable condition -- e.g. stable diabetes), OR
- (b) it is a condition not directly related to the reason(s) for admission, but its treatment is being actively managed -- and by actively we mean that during this admission changes are made to the management.
- Example2: Patient with TB has been treated for the past 5 (of his 9 expected) months admitted now for acute MI.
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Onset not discovery
Acquired diagnoses do not refer to diagnoses that have been discovered after the patient comes to the unit if it is likely that the patient was admitted to ward with the problem in the first place but it took a few days to figure that out. Code these as Comorbid Diagnosis, and also, if appropriate (i.e. it was related to the reason for admission) as a Admit Diagnosis.
Diagnosis categories in relation to patients moving around the hospital
- This section explains how to determine the Dx Types as a patient moves from place to place within a hospital -- i.e. during a single hospitalization. In this section we'll refer to a person who moves from A to B to C (e.g. A and C are ICU while B is ward; so 3 separate records in the database)
- Rule#1: Situation where a diagnosis is NEW to this hospitalization [i.e. either it: (a) was an Admit Diagnosis to location A that was not a chronic, pre-existing disorder before hospitalization, OR (b) developed after admission, as an acquired diagnosis while in location A], then:
- when you start records B or C do NOT include that diagnosis as a comorbid
- if by the time they are transferred to the subsequent location it is resolved and no longer being treated, then it should not show up as any kind of diagnosis for that subsequent record
- if by the time they are transferred to the subsequent location it is still being dealt with medically, and indeed is part of the reasons they are going to the new location, then it should be listed as an Admit Diagnosis for that subsequent record
- Rule#2: The group of diagnoses that represent "past history" (e.g. Past history, loss of limb(s) are also guided by Rule#1.
- Rule#3: The "duration" of a diagnostic event (e.g. pneumonia vs. an arrythmia) has no role in decision-making about how these diagnoses are listed (or not)
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Rules 1 and 2 are clear, could rule 3 be further clarified
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This wiki page talks about which ICD10 codes are allowed to be Comorbid Diagnosis vs. Admit Diagnosis vs. Acquired Diagnosis Dx Type. See Controlling Dx Type for ICD10 codes for a discussion about cross-checks for these.
Repeating Complications
- In general things that occur, fully resolve, and then recur SHOULD be coded each time they recur.
- e.g. postop hemorrhage --> goes to OR to have it fixed --> IS fixed ---> 3 days later has more postop hemorrhage
- For things that happen multiple times, some we WANT to list multiply and others we only list once
- The ones we only list once include that info: Template:ICD10 Guideline repeated events. These are generally signs/symptoms, and arrythmias.
- Otherwise, DO list it multiply --- e.g. after admit has a stroke --> 4 days later has a NEW/DIFFERENT stroke.
Data Structure
Acquired Diagnoses are drawn from S_ICD10 table and stored in L_ICD10 table.
Cross checks
Related articles
Related articles:
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- Main Page (← links)
- Admit Diagnosis (← links)
- Green sheet (← links)
- Complications (redirect page) (← links)
- Hypertension (← links)
- Comorbid Diagnosis (← links)
- Critical Care and Medicine Database Core Curriculum (← links)
- Auto Data Dictionary (← links)
- QA Infection VAP (← links)
- L ICD10 table (← links)
- ICD10 collection (← links)
- Dx Date (← links)
- Dx Type (← links)
- Hallucinogen, acute intoxication (← links)
- Alcohol (ethanol) acute intoxication (drunkenness) (← links)
- Opioid/narcotic, acute intoxication (← links)
- Sedative or hypnotic, acute intoxication (← links)
- Cocaine, acute intoxication (← links)
- Solvent (organic, inhaled or ingested), intoxication, acute (← links)
- Psychoactive substance NOS, acute intoxication (← links)
- Myocardial infarction, acute (AMI), transmural (Q-wave) (← links)
- Myocardial infarction, acute (AMI), subendocardial/non-transmural (non-Q-wave) (← links)
- Myocardial infarction, acute (AMI), NOS (← links)
- Past history, myocardial infarction (old MI) (← links)
- Pneumonia, ventilator-associated (VAP) (← links)
- Respiratory failure (insufficiency), chronic (← links)
- Iatrogenic, infection, central venous catheter-related bloodstream infection (CVC-BSI, CLI) (← links)
- Homelessness (← links)
- Chronic dependence on mechanical ventilator (← links)
- Template:ICD10 Guideline MI acute vs past history (← links)
- L ICD10 subform (← links)
- Infections in ICD10 (← links)
- Dx Date unknown (← links)
- Diagnostic Data available in the Critical Care and Medicine Database (← links)
- Public Entrance Likely Initial Page (← links)
- Stimulants incl methamphetamine, acute intoxication (← links)
- Controlling Dx Type for ICD10 codes (← links)
- Data Integrity Checks (← links)
- Acquired Diagnosis (redirect page) (← links)
- Palliative care (← links)
- Admit Diagnosis (← links)
- Acquired Diagnosis / Complication (← links)
- Comorbid Diagnosis (← links)
- Check CRF vs ARF across multiple encounters (← links)
- Query NDC VAP no TISS (← links)
- Check BRR/XBR vs cardiac arrest dx (← links)
- Pacemaker insertion (TISS Item) (← links)
- Acute myocardial infarction complication of Dressler's syndrome (postmyocardial infarction syndrome) (← links)
- Depression (major depressive disorder, recurrent depression) (← links)
- Pneumonia, ventilator-associated (VAP) (← links)
- Shock, septic (← links)
- Iatrogenic, infection, related to vascular access other than central line (← links)
- Iatrogenic, infection, following a procedure or surgery, NOS (← links)
- Iatrogenic, infection, heart valve prosthesis (incl prosthetic valve endocarditis) (← links)
- Iatrogenic, infection, cardiac or vascular prosthetic device or implant or graft NOS (← links)
- Iatrogenic, infection, central venous catheter-related bloodstream infection (CVC-BSI, CLI) (← links)
- Iatrogenic, infection, urinary catheter (← links)
- Iatrogenic, infection, internal orthopedic prosthetic device or implant or graft or bone device (← links)
- Iatrogenic, infection, internal prosthetic device or implant or graft NOS (← links)
- Sepsis (SIRS due to infection, without acute organ failure) (← links)
- Severe sepsis (← links)
- Template:ICD10 Guideline Como vs Admit (← links)
- Data Integrity Checks (← links)
- Query check AIDS vs HIV (← links)
- Query check ICD10 date (← links)
- Data Integrity Check under review (← links)
- Query NDC VAP AcqDX but NoVAP DateinTMPV2 (← links)
- Query NDC VAP No AcqDX but VAP DateinTMPV2 (← links)
- User:Ttenbergen/questions for tina (← links)
- Check VAP acquired only first encounter (← links)
- Template:ICD10 Guideline Iatrogenic (← links)
- Template:ICD10 Guideline Sepsis (← links)
- Nosocomial infection, NOS (← links)
- Guideline for coding organ donation after death (← links)
- Attribution of infections (← links)
- COVID-19 (SARS-COV-2) (← links)
- 2020 GRA COVID unit transition (← links)
- 2020-04 HSC COVID unit transition (← links)
- To do list (← links)
- 2020-05 HSC COVID unit transition (← links)
- Template:ICD10 Guideline Admit vs Acquired (← links)
- Query check ICD10 date (← links)
- Query NDC VAP AcqDX but NoVAP DateinTMPV2 (← links)
- Query NDC VAP No AcqDX but VAP DateinTMPV2 (← links)
- Template:ICD10 Guideline acute intoxication (← links)
- Cannabis/cannabinoids, acute intoxication (← links)
- Acquired Diagnoses (redirect page) (← links)
- Template:DataDictionaryQuery (← links)
- Data dictionary (← links)
- Collector dictionary (← links)
- Template:CollectorDictionaryQuery (← links)
- Task Team Meeting - Rolling Agenda and Minutes 2019 (← links)
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