hypovolemic shock and AHRQ indicators
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.
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
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
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
I have one question, how carotid artery occlusion (433.10) related to stroke? Someone in our hospital coded it as nonspecific stroke.
thanks
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