post CABG encephalopathy and STS database

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in CDI Talk Archive
We are getting push back from our cardiac surgeons when we query for post CABG encephalopathy because of changes in the STS (Society of Thoracic Surgeons) database and how this diagnosis is counted. Prior to Dec 09, any non permanent neurological dysfunction was codes in their DB as 'other'. Per our STS database manager, this changed in Dec 09 and the physician leadership from STS says that metabolic &/or anoxic encephalopathy should be coded as 'complications stroke permanent' if it lasts >24 hrs. Their coding has nothing really to to with ICD-9 coding and they have specific criteria for each diagnosis.
Has anyone else had experience with this and how are you handling it?
thanks, Julie Doy

Comments

  • sbeattysbeatty
    edited May 2016
    Section V. of the STS training manual v2.61, which appears to be the
    current standards per the STS website, states:
    Section P: Complications
    Sequence 2830, Complications, neuro-stroke perm

    Data field intent: Indicate whether the patients has a post-operative
    stroke (i.e., any confirmed neurological deficit of abrupt onset caused
    by a disturbance in cerebral blood supply) that did not resolve within
    24 hours.

    Field name intent: Central events are caused by embolic or hemorrhagic
    events. Neurological deficits such as confusion, delirium and/or
    encephalopathic (anoxic or metabolic) events are NOT to be coded in this
    field.

    Example #3: .....Neurology was consulted and documentedthat the mental
    status changes were due to encephalopathy and not infarcts. The
    confusion persisted beyond 24 hours: The patient had a central
    neurological deficit that persisted longer than 24 hours. Code the
    Stroke Permanent.

    This is likely the item to which reference is being made.


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