Admit Procedure
This page explains when a CCI Procedure that is part of CCI Collection would be coded with Px Type Admit. The instructions are the same for medicine an critical care. The other option for type is Acquired Procedure.
Collection Instructions
- Code a procedure as Px_Type 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 section and examples below
- If an admit procedure that qualifies is done more than once on two different calendar days, enter it once and set the count to the appropriate number
- It won't always be so clear if a procedure is related to the admission, and you may have to use your judgement.
- VERY IMPORANT DISTICTION: A procedure that simply identified the presence of a problem should not be considered to have caused the problem, and so should not be put into this category.
- While causally-related procedures will usually be invasive procedures, they do not NEED to be -- e.g. if a person is admitted for expressly Isolation, infectious, this could be in this bin.
- And on occasion, even a diagnostic procedure could be causative --- e.g. a contrast-enhanced X-ray where the contrast caused anaphylaxis that led to ICU admission. But this kind of example is the only kind of situation in which a non-invasive diagnostic procedure should be in this bin. So, things we count, such as CXRs and blood gases, would NOT be in this bin, unless somehow they actually CAUSED a problem that led to admission (e.g. blood gas puncture injured the artery, leading to a huge bleed for which they went to ICU).
example of causally related procedures |
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example of procedure not causally related |
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These instructions would imply that a patient who had a scope and banding/clipping down in ER for their GI bleed, should not be coded. I would think that we would want to capture an intervention if it treated the reason for admission?Mlagadi 10:18, 2018 October 18 (CDT) |
Moved patients
A procedure might be coded as an acquired on one ward and an admit on the next - the same as above applies.
example of procedures for moved patient |
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Admission solely for follow up care
If
- a patient is admitted to our ward/unit solely for Surgical follow-up care
- the procedure itself would not have been coded by us because the first post-procedure ward was not one where we collect (or wasn't even at a WPG hospital)
Then
- Code Surgical follow-up care
- code the CCI procedure that is being followed up as Admit Procedure, removing FOR THIS USAGE ONLY any rules that would stop you from coding a procedure as an Admit Procedure
Example: |
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For this usage, there is no time limit on when the procedure was done but nonetheless it must include the judgement that the reason for this admission was "routine" followup surgical care related to that procedure --- AS OPPOSED TO admission for some complication of that procedure.
If instead the admission was for a complication of that procedure, and not routine followup surgical care, then code the procedure as an Admit Procedure and code the complication as the Admit Diagnosis, and as a Comorbid Diagnosis one of the "Past medical history" codes:
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Why within 24 hrs?
This was an arbitrary decision because we needed a cut-off.