CMS Hospital Readmission Reduction Program

evanspx@sutterhealth.orgevanspx@sutterhealth.org
in CDI Talk Archive
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

Comments

  • kerryseekircherkerryseekircher
    edited April 2016
    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.comlaura.bohls@prairielakes.com
    edited April 2016
    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


  • catladyrncatladyrn
    edited April 2016
    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
  • kerryseekircherkerryseekircher
    edited April 2016
    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.orgnatalie.esquibel@sclhealth.org
    edited April 2016
    Can you send to me as well
    Thank you
    Natalie.esquibel@sclhs.net


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