hypovolemic shock and AHRQ indicators

edited May 2016 in CDI Talk Archive
We have discovered that our organization is a statistically significant
outlier for post-operative sepsis. Yikes! By drilling down on these
charts, we discovered that hypovolemic shock coded 78559 (shock w/o
trauma NEC) is included in the AHRQ list of codes that are indicative of
post-op sepsis and this appears to be driving our less than stellar
performance picture. We feel we give exceptional care and need to
understand why this isn't an issue for other organizations, but is for
us.



Do any of you know what your organization is doing in such cases? Do you
query for something else that is more clear and reflective of the
patient's condition? We are in a quandary because the clinical picture
is supported by the code for hypovolemic shock, but there is nothing
that even remotely implies or describes a clinical picture of sepsis for
these cases.



We have decided to ask members of AHIMA and ACDIS what others are doing
or have found when reviewing your AHRQ data for post-op sepsis. We want
to code correctly and believe we have. So why do we look different than
others? Our next step, depending on what we learn from our colleagues,
is to ask the Indiana Hospital Association to contact AHRQ about the
inappropriate inclusion of the hypovolemic shock code as an indicator of
post-op sepsis. Is anyone interested in joining our grass-roots
movement? Thanks for your time and attention.

Comments

  • Since hypovolemic shock is coded as 785.59 and septic shock is coded as
    785.52, it appears to me AHRQ has included 785.59 incorrectly. and it
    this has resulted in incorrect reporting.



    I will forward your message to our quality representatives familiar with
    the AHRQ reporting requirements.



    Paul Evans, RHIA, CCS, CCS-P

    Supervisor, Clinical Documentation Integrity

    California Pacific Medical Center

    2351 Clay #243

    San Francisco, CA 94115

    Cell: 415.637.9002

    Fax: 415.600.1325

    Ofc: 415.600.3739

  • When I look at the PSI 13 codes, there is an asterisk next to 785.59 and says not effective for discharges 10/1/2004. V4.0 change says remove the code, and I don't see anything in the later updates that adds it back in.

    Is this code being applied inappropriately in your facility? Because if it's affecting you, it should be affecting everyone.

    Renee


    Linda Renee Brown, RN, CCRN, CCDS
    Certified Clinical Documentation Specialist
    Banner Good Samaritan Medical Center
  • edited May 2016
    Hi, all,
    I have one question, how carotid artery occlusion (433.10) related to stroke? Someone in our hospital coded it as nonspecific stroke.

    thanks


  • edited May 2016
    per their technical guidelines 785.59 is not valid for discharges after
    10/1/04. However, I have not looked the users guidelines-which based on
    the PU PSI we know the technical and the user guidelines don't always
    match....


    Sincerely,

    Karen A. Johnson

    Clinical Documentation Improvement, 216-444-3559



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