CMS Hospital Readmission Reduction Program

evanspx@sutterhealth.org

Hello - I am working on PNA readmissions and I have a question - Do the following conditions 'exclude' a patient from the PNA readmissions criteria, if appropriate, and when sequenced as the Principal Diagnosis?

1. Aspiration PNA
2. COPD Exacerbation
3. Sepsis
4. Acute Respiratory Failure

kerryseekircher

I have an article on this- email me at kseekircher@nwhc.net and I will share it with you. Off the top of my head, I am certain that asp Pna, sepsis and resp failure are excluded.
Kerry

laura.bohls@prairielakes.com

I would be interested in the article also. Is there any way you could post the link? I'm sure there are others that are interested also

Laura Bohls, RN
Clinical Documentation Specialist
605-882-5454

catladyrn

I may not be reading your question correctly, but my understanding is that pneumonia (and aspiration pneumonia is not included) must be the principal diagnosis for the index admission, and readmissions within 30 days can be for any reason. However, a number of conditions are risk adjustment variables in determining predicted/expected readmissions, including sepsis, COPD and respiratory failure, unless they only occur during the index admission, in which case they are considered complications of care.

Renee

Linda Renee Brown, RN, MA, CCDS, CCS, CDIP
Director, Clinical Documentation
Tanner Health System

kerryseekircher

I don't have a link-it's a pdf file.
Feel free to email me.

Kerry Seekircher, RN, BSN, CCDS, CDIP
Documentation Specialist Supervisor
Northern Westchester Hospital
400 East Main Street
Mount Kisco, NY 10549
Email: kseekircher@nwhc.net
Phone: 914-666-1243
Fax: 914-666-1013

natalie.esquibel@sclhealth.org

Can you send to me as well
Thank you
Natalie.esquibel@sclhs.net