|Data Element (edit)|
|Field Name:||Dx primary|
|CCMDB Label:||not stated|
|Table:||L ICD10 table|
|Program:||Med and CC|
The Dx primary is coded as part of the ICD10 collection.
On the ICD10 tab in CCMDB.accdb, the Dx Primary check box is to the left of the Dx Type. Check off the box for the ONE Admit Diagnoses that is the Primary Admit Diagnosis. The diagnosis with this check mark should be one of those with the lowest Dx Priority used for an Admit Diagnosis.
Admitted with: Pneumonia, NOS which is noted to be not severe, and CVA which is severe
For reporting purposes, Julie puts the primary diagnosis into 8 different categories:
Traditionally we have put the "primary" diagnosis as the main reason they are in the ICU (or ward). The problem is that the reason they came may not really fit the proper category in all cases. For example, the patient came to the ICU with respiratory failure requiring intubation, however the patient may have sepsis which caused the respiratory failure and technically we should be putting sepsis as our primary. Another example is cardiac arrest which traditionally has always been put as the primary diagnosis. However, it does not always capture the correct category which is why they went into cardiac arrest. They may have had an overdose or an airway obstruction or apnea or sepis or it may be a true cardiac event. We would put the cause still as #1 along with the cardiac arrest but it would be missed because Julie only picks up the primary (checked) diagnosis. Putting cardiac arrest as primary can miss the true category. To make it even more complicated however, there is a category for cardiac arrest so which is more important to capture? We all need direction on which diagnosis is "primary". --LKolesar 13:38, 2019 June 25 (CDT)
Data Integrity Checks (SMW)
|Query check dx primary not exactly one||CCMDB.accdb||implemented|
|Query check dx primary lowest priority||CCMDB.accdb||implemented|
|Check if awaiting code is primary dx then Transfer Ready DtTm must be equal to Arrive DtTm||CCMDB.accdb||implemented|