Transfer for bed management
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| ICD10 Diagnosis | |
| Dx: | Transfer for bed management |
| ICD10 code: | Z75.3 |
| Pre-ICD10 counterpart: | none assigned |
| Charlson/ALERT Scale: | none |
| APACHE Como Component: | none |
| APACHE Acute Component: | none |
| Start Date: | 2025-11-28 |
| Stop Date: | |
| Data Dependencies(Reports/Indicators/Data Elements): | No results |
| External ICD10 Documentation | |
This diagnosis is a part of ICD10 collection.
Excludes: transfers for repatriation
- We DEFINE bed repatriation as a transfer of back to their local hospitals outside of WRHA
- We exclude this here because repatriation is standard practice
Additional Info
- This is to identify service transfers for bed management -- as opposed to transfer for medical reasons (e.g. patient transferred from Grace ICU to HSC MICU for dialysis)
- most commonly this is to clear a bed from a full sending unit so it can admit a patient
- service transfer should also be considered to be for bed management in the more complicated situation e.g. patient started out in Grace ICU --> developed renal dysfunction --> transferred for medical necessity to ICMS for dialysis --> kidneys improved and no longer needed dialysis --> transferred back to Grace ICU -- THIS transfer back should be coded as for bed management -- i.e. patient is transferred BACK to the original service after prior transfer for medical necessity.
- With just one exception, this code should ONLY be used if the patient is transferred from one service on which we collect, to another service on which we collect, both at the same level (e.g. ICU-ICU, or ward-ward)
- The exception is transfers FROM ward TO low Acuity Units (LAU) and similar location types. (Note: this is in relation to a bed management project being done by Dan and Tina). But only use this if the patient actually goes to LAU, i.e. not if patient is on the list for LAU transfer, but ends up being discharged from hospital before transfer occurs.
- So, it should NOT be used when a patient goes: ICU service to ward service; Ward service to ICU service; ICU service to IICU service; ED on ED service to anywhere
- It should be coded as:
- An Acquired Diagnosis from a collection unit that is transferring a patient out
- An Admit Diagnosis for the collection unit that is taking the patient in transfer
- Dx Date - if available, use the date the decision to transfer for medical reasons was documented, otherwise use the Dispo DtTm
- The Admit Diagnosis should not be linked with primary Admit Diagnosis but prioritized lowest.
- For any transfer, it is possible that only the sending or only the receiving unit is one where we collect, so a counterpart may or may not exist
- This code will often mean that a patient would have a Transfer Ready DtTm tmp entry before this code's Dx Date for Medicine records, but not necessarily for Critical Care records since the GRA ICU has the same Level of care as the HSC and STB ICUs, only with fewer attached services.
Relationship between Intended1stSrvc and Transfer for bed management
- Keeping track of this requires remembering that ICU database records are according to ICU service, not location. Thus, when the service changes the patient gets a new ICU record, while a change of physical location with no change in ICU service is not a new record (it's just a change in Boarding Loc).
- Intended1stSrvc only applies when a patient is initially admitted to an ICU service from a non-ICU location (e.g. ED, ward) -- it DOES NOT apply to direct transfer from one ICU service to a different ICU service (i.e. ICU-to-ICU transfer). If a patient undergoes direct ICU-to-ICU transfer for bed management reasons, the sending ICU record should have Transfer for bed management as an Acquired Diagnosis, while the receiving ICU record should have Transfer for bed management as an Admit Diagnosis
- Transfer for bed management only applies to direct ICU-to-ICU service transfers.
- and this is regardless of the physical location of the patient upon that transfer, e.g. a patient who is "ECIP", still physically in ED but has been officially admitted to an ICU service, can have Transfer for bed management, but cannot have Intended1stSrvc because such a patient has already been admitted to an ICU service and any opportunity to code Intended1stSrvc would apply to that initial ICU record when they were admitted to that first ICU service.
- Although it IS possible for a single ICU record to include BOTH of these, they would be for different ends of the ICU record, i.e. the beginning vs. the end
- e.g. Patient with pneumonia in HSC ED is admitted to SICU on SICU service due to lack of MICU beds. So that SICU service record has Intended1stSrvc=MICU, Service/Location=SICU, and Boarding Loc=SICU . Two days later, SICU has a bed crunch and the patient is transferred to Grace ICU, so in the SICU database record Transfer for bed management is coded as an Acquired Diagnosis, while the Grace ICU record will have Transfer for bed management coded as an Admit Diagnosis.
Alternate ICD10s to consider coding instead or in addition
Candidate Combined ICD10 codes
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Data use
- The absence of this code will mean that a transfer was "for medical reasons".
- We decided that instead of doing a consistency check to ensure that the sending and receiving units both have this diagnosis coded, that in doing reporting Julie will consider the transfer to be for bed management if it was coded in either the sending or receiving unit
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Data Integrity Checks (automatic list)
none found
- review #Data use before considering cross checks
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