Dx Primary

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Data Element (edit)
Field Name: Dx primary
CCMDB Label: not stated
CCMDB tab: ICD10
Table: L ICD10 table
Data type: boolean
Length: not stated
Program: Med and CC
Created/Raw: Raw
Start Date: 1900-01-01
End Date: 2300-01-01
Sort Index: 8

Checkbox that is set to true for a single Admit Diagnosis per ward stay that is the Primary Admit Diagnosis

The Dx primary is coded as part of the ICD10 collection.

Collection Instructions

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.

Example:   
Admitted with: Pneumonia, NOS which is noted to be not severe, and CVA which is severe  
    • Primary Reason to be checked off: CVA.

Background

Discuss@task.png

For reporting purposes, Julie puts the primary diagnosis into 8 different categories:

  • respiratory disorders
  • post cardiac arrest
  • trauma and poisoning
  • metabolic/renal/GI/hypovolemic shock
  • cardiac disease
  • neurologic disorder
  • post-operative care
  • sepsis/septic shock

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)

    • I guess the question is if any dxs can not be captured in those 8 groups. If they are all captured there is no problem, or is there? Ttenbergen 10:09, 2019 October 4 (CDT)
  • SMW


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  • Categories

Data Integrity Checks (SMW)

 AppStatus
Query check dx primary not exactly oneCCMDB.accdbimplemented
Query check dx primary lowest priorityCCMDB.accdbimplemented
Check if awaiting code is primary dx then Transfer Ready DtTm must be equal to Arrive DtTmCCMDB.accdbimplemented

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