Acquired Diagnosis / Complication

For other types of diagnoses, see Admit Diagnosis and Comorbid Diagnosis.

• Acquired Diagnoses, also referred to as complications, are diagnoses that happen to a patient after the start of the database record in question, i.e. after the Arrive DtTm. An Acquired Diagnosis / Complication is coded by setting the Dx_Type to "acquired".
• Distinction between admit and acquired diagnoses relate to the START of a database record. As of October 2020, a single record may span direct transfers between different locations and even between different services. Accordingly, an admit diagnosis only relates to the very start of a database record. Diagnoses that occur after the start of a database record will be acquired diagnoses.
  • Example -- 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.

• See Admit Diagnosis and Comorbid Diagnosis for info on coding dxs that happen prior to arrival on your ward.
• 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.

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.

this relates to Attribution of infections and we need to be sure to have it consistent.

• SMW

• Cargo

• Categories

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

• Query check ICD10 date