Task Team Meeting - Rolling Agenda and Minutes 2023

List of items to bring to task meeting

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wiki page	question	Last modified
wiki page	question	Last modified
Gangrene, NOS	can we use this code for necrosis or necrotic wounds? Lisa Kaita 11:57, 2024 April 17 (CDT)	2024-04-17 5:03:39 PM
Hemothorax or hemopneumothorax, nontraumatic	Just wondering whether this code could be combined with iatrogenic causes similar to the guideline for: Guideline for Iatrogenic Pneumothorax According to our general rule of not coding iatrogenic events as traumas, code an iatrogenic pneumothorax as Iatrogenic, puncture or laceration, related to a procedure or surgery NOS Plus the most appropriate of the following; Pneumothorax, tension, nontraumatic Pneumothorax, nontension, nontraumatic Pneumothorax, nontraumatic, NOS Thanks, Pamela Piche 08:55, 2024 March 19 (CDT) Allan made the initial entry of not to use this as an iatrogenic or trauma code in 2017, so let's discuss this at TASK Lisa Kaita 15:03, 2024 April 5 (CDT)	2024-04-05 8:03:05 PM
Iatrogenic, mechanical complication/dysfunction, internal prosthetic device or implant or graft NOS	At our last TASK meeting the decision was made to exclude spontaneous rupture of an ETT cuff or cuff leak, but we are wondering if this is correct based on what is listed in the includes section of this page and what is in Iatrogenic, mechanical complication/dysfunction, internal orthopedic prosthetic device or implant or graft or bone device and Iatrogenic, mechanical complication/dysfunction, cardiac or vascular prosthetic device or implant or graft, NOS Lisa Kaita 12:37, 2024 March 20 (CDT)	2024-03-20 5:37:32 PM
Myocardial infarction, acute (AMI), NOS	ICD 10 has this code for STEMI: 2024 ICD-10-CM Diagnosis Code I21.3 ST elevation (STEMI) myocardial infarction of unspecified site that includes transmural (Q wave) infarction ICD 10 has this code for NSTEMI: 2024 ICD-10-CM Diagnosis Code I21.4 Non-ST elevation (NSTEMI) myocardial infarction that includes Nontransmural myocardial infarction NOS Would it be less labor intensive for collectors to be able to use these codes instead of MI codes dependent upon development (or not) of Q waves as this is problematic to determine. Thank you, Pamela Piche 07:49, 2024 April 5 (CDT) I have added this to TASK, in 2019 ICD 10 did not have STEMI/NSTEMI codes, now in the 2024 version they do, I agree with Pam can we switch to the new codes? Lisa Kaita 15:10, 2024 April 5 (CDT)	2024-04-05 8:10:42 PM
Sepsis (SIRS due to infection, without acute organ failure)	How hard of a rule is lactate >2? If they meet the criteria for septic shock with the exception of a high enough lactate, can we code septic shock Lisa Kaita 12:17, 2024 April 17 (CDT)	2019-03-09 9:24:42 PM
Sepsis (SIRS due to infection, without acute organ failure)	When the progression is very fast eg. admitted at 0100 with severe sepsis, lactate 1.7, then at 0220 lactate is now 2.7 do we use the admit severe sepsis and code the septic shock as acquired? Lisa Kaita 12:17, 2024 April 17 (CDT)	2019-03-09 9:24:42 PM
Severe sepsis	How hard of a rule is lactate >2? If they meet the criteria for septic shock with the exception of a high enough lactate, can we code septic shock Lisa Kaita 12:17, 2024 April 17 (CDT)	2019-10-31 3:04:29 PM
Severe sepsis	How hard of a rule is lactate >2? If they meet the criteria for septic shock with the exception of a high enough lactate, can we code septic shock Lisa Kaita 12:17, 2024 April 17 (CDT)	2022-02-17 10:56:05 PM
Severe sepsis	When the progression is very fast eg. admitted at 0100 with severe sepsis, lactate 1.7, then at 0220 lactate is now 2.7 do we use the admit severe sepsis and code the septic shock as acquired? Lisa Kaita 12:17, 2024 April 17 (CDT)	2019-10-31 3:04:29 PM
Severe sepsis	When the progression is very fast eg. admitted at 0100 with severe sepsis, lactate 1.7, then at 0220 lactate is now 2.7 do we use the admit severe sepsis and code the septic shock as acquired? Lisa Kaita 12:17, 2024 April 17 (CDT)	2022-02-17 10:56:05 PM
Shock, septic	How hard of a rule is lactate >2? If they meet the criteria for septic shock with the exception of a high enough lactate, can we code septic shock Lisa Kaita 12:17, 2024 April 17 (CDT)	2019-01-10 7:32:04 PM
Shock, septic	When the progression is very fast eg. admitted at 0100 with severe sepsis, lactate 1.7, then at 0220 lactate is now 2.7 do we use the admit severe sepsis and code the septic shock as acquired? Lisa Kaita 12:17, 2024 April 17 (CDT)	2019-01-10 7:32:04 PM
STB ICUs VAP Rate, CLIBSI Rate Summary	IIRC we collected CAM positive (TISS Item) specifically for this, right? If so, can we stop collecting it? And can we make sure a stoppage like this in the future results in reviewing what we collect? Ttenbergen 10:02, 2024 March 20 (CDT) Delirium rate per 1000 days per unit is being reported in the OIT Reports. ---JMojica 11:49, 2024 March 20 (CDT) As in Delirium days is reported in Critical Care Program Quality Indicator Report? But that doesn't mention anything about per-1000-days. Ttenbergen 17:00, 2024 March 20 (CDT) The rate is mentioned in the succeeding definition with the delirium days as numerator. Your proposal here is to stop collecting TISS item CAM positive which I disagree because that TISS item is being used and reported as rate in OIT Report. Besides, the reason why it was dropped in in the STB VAPCLI report is because the requestor has changed. Brett Hiebert who used to request this was involved in the VAP group and another Delirium group so he asked to have both as one request. Brett had left and the VAP group filled up a new request to continue the VAP data and not on the delirium data. --JMojica 13:58, 2024 March 25 (CDT)	2024-04-08 4:27:53 PM
Stroke, NOS	we need clarification on when to use this code, eg. if there is a history where it says a history of stroke, or if on CT they comment remote lacunar infarcts? Lisa Kaita 12:01, 2024 April 17 (CDT)	2024-04-17 5:01:53 PM
Template:ICD10 Guideline Sepsis	How hard of a rule is lactate >2? If they meet the criteria for septic shock with the exception of a high enough lactate, can we code septic shock Lisa Kaita 12:17, 2024 April 17 (CDT)	2024-04-17 5:17:33 PM
Template:ICD10 Guideline Sepsis	When the progression is very fast eg. admitted at 0100 with severe sepsis, lactate 1.7, then at 0220 lactate is now 2.7 do we use the admit severe sepsis and code the septic shock as acquired? Lisa Kaita 12:17, 2024 April 17 (CDT)	2024-04-17 5:17:33 PM

Also see Task Team Meeting - Rolling Agenda and Minutes 2022

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ICU Database Task Group Meeting – Jan 11, 2023

Copied here as starting point for 2023, please edit/overwrite

• Present: Allan, Gail, Julie, Michelle, Mindy, Stephanie, Tina, Val, Pagasa, Mailah
• Minutes prepared by: AG
• Action items in BOLD

1. Transition to Database Server#Shared Health - Nothing new about either of the possible alternative options for hosting the database.

2. Controlling Dx Type for ICD10 codes - Regarding the task to improve data collector diagnosis assignment into the 3 "bins" of admission diagnosis, acquired diagnosis and comorbid diagnosis.

• Lisa indicated that for a first pass on this, she will distribute all the codes among all the collectors.

3. New item: Clarification of Pulmonary emphysema or bullous disease without COPD. Allan modified this Wiki entry to make it clearer.

4. New item: Regarding the code Sudden cardiac death (and died)

• After discussion we recognized that we have no need to specifically code patients' cause of death. We know it occurred by virtue of the Dispo field. Thus we agreed to remove this item from the list of ICD-10 codes, and to have Julie go into all records where it has been recorded and remove it. Allan modified the Wiki page also.

5. New question: It was noticed that an error occurs if a diagnosis of Influenza is recorded (which is an implied bug) and one attempts to combine it with a Nosocomial problem code. Tina will fix this.

6. Followup item from long ago: Seeking to get ABGs at Grace Hospital to be included in the Lab Info System (LIS).

• The last time we tried for this, in 2015, the resp therapy group at Grace was not interested in being required to manually logging this information into LIS, as IS done at HSC and St. B.
• We think they may be more open to it now -- so today Allan emailed Heather Smith, asking her to raise it with them.
• If they indeed are willing, Allan will talk to Dr. Soroko about getting it implemented.

7. New item: Uncertainty of when/how to use Complication of labor and delivery, NOS

• As our database is only for adult patients, this code should not be used to indicate such a complication for a newborn. For example: During hospitalization, such a complication occurs, but it only affects the newborn and has no medical consequence for the mother --- do NOT use this code.
• Of course, for some such complications when the newborn with a complication becomes an adult, that problem persists, e.g. Fetal Alcohol Syndrome. If that adult is then admitted, it is the specific problem (such as Fetal Alcohol Syndrome) that should be listed as a Comorbid Diagnoses -- again you would NOT code Complication of labor and delivery, NOS.
• The only time Complication of labor and delivery, NOS would be coded is when the mother herself incurs a complication of labor or delivery, AND there is not a more specific code for the complication she suffered.
• Allan modified this Wiki page for clarity.

8. New item: Clarification of when/how to use Oral mucositis

• This code is for widespread or diffuse oral mucus membrane involvement -- as often occurs after some chemotherapies, and a few other causes.
• Do not use it for localized oral lesions or involvement in just a part of the oral mucosa. In such a case code the specific cause if known, and otherwise use Disorder of oral mucosa (mouth, lips, tongue), NOS.
• Allan has updated the Wiki to reflect this.

2022...

Also see Task Team Meeting - Rolling Agenda and Minutes 2022