Psi Technical Specs V30a.Pdf

AHRQ Quality Indicators Patient Safety Indicators: Technical Specifications Department of Health and Human Services Agency for Healthcare Research and Quality http://www.qualityindicators.ahrq.gov March 2003 Version 3.0a (May 1, 2006) AHRQ Quality Indicators Web Site: http://www.qualityindicators.ahrq.gov Table of Contents Complications of Anesthesia (PSI 1) ............................................................................................................ 1 Death in Low-Mortality DRGs (PSI 2) ........................................................................................................... 3 Decubitus Ulcer (PSI 3) ................................................................................................................................. 5 Failure to Rescue (PSI 4) .............................................................................................................................. 7 Foreign Body Left during Procedure, Secondary Diagnosis Field (PSI 5 and 21)...................................... 14 Iatrogenic Pneumothorax, Secondary Diagnosis Field (PSI 6 and 22)....................................................... 15 Selected Infections Due to Medical Care, Secondary Diagnosis Field (PSI 7 and 23) .............................. 21 Postoperative Hip Fracture (PSI 8) ............................................................................................................. 21 Postoperative Hemorrhage or Hematoma (PSI 9 and 27) .......................................................................... 25 Postoperative Physiologic and Metabolic Derangement (PSI 10) .............................................................. 27 Postoperative Respiratory Failure (PSI 11) ................................................................................................ 29 Postoperative Pulmonary Embolism or Deep Vein Thrombosis (PSI 12) ................................................... 30 Postoperative Sepsis (PSI 13) .................................................................................................................... 30 Postoperative Wound Dehiscence (PSI 14 and 24)) .................................................................................. 31 Accidental Puncture or Laceration, Secondary Diagnosis Field (PSI 15 and 25)....................................... 38 Transfusion Reaction, Secondary Diagnosis Field (PSI 16 and 26) ........................................................... 38 Birth Trauma―Injury to Neonate (PSI 17) .................................................................................................. 39 Obstetric Trauma―Vaginal Delivery with Instrument (PSI 18) ................................................................... 41 Obstetric Trauma―Vaginal Delivery without Instrument (PSI 19) .............................................................. 42 Obstetric Trauma―Cesarean Delivery (PSI 20) ......................................................................................... 43 Appendix A: Operating Room Procedure Codes ..................................................................................... A-1 Appendix B: Surgical Discharge DRGs .................................................................................................... B-1 Appendix C: ICD-9-CM Trauma Diagnosis Codes................................................................................... C-1 Appendix D: ICD-9-CM Codes for Immunocompromised States ............................................................. D-1 Appendix E: Cancer Codes ...................................................................................................................... E-1 Appendix F: Medical Discharge DRGs ..................................................................................................... F-1 Appendix G: Hemorrhage Diagnosis Codes ............................................................................................. G-1 Appendix H: Shock Diagnosis Codes ...................................................................................................... H-1 Appendix I: ICD-9-CM Gastrointestinal (GI) Hemorrhage Diagnosis Codes ............................................ I-1 Appendix J: Trauma DRGs ....................................................................................................................... J-1 Appendix K: Pulmonary Embolism/Deep Vein Thrombosis Diagnosis Codes ........................................ K-1 Appendix L: Self-Inflicted Injury Diagnosis Codes .................................................................................... L-1 Appendix M: Acute Myocardial Infarction (AMI) Diagnosis Codes .......................................................... M-1 Appendix N: Cardiac Arrhythmia Diagnosis Codes ................................................................................. N-1 Appendix O: Sepsis Diagnosis Codes ..................................................................................................... O-1 Appendix P: Infection Diagnosis Codes and DRGs ................................................................................. P-1 Appendix Q: Cancer DRGs ....................................................................................................................... Q-1 PSI Technical Specifications i Version 3.0a (May 1, 2006) AHRQ Quality Indicators Web Site: http://www.qualityindicators.ahrq.gov Patient Safety Indicators – Detailed Definitions For ICD-9-CM codes introduced after October 1995, the date of introduction is indicated after the code label, e.g., OCT 04. Complications of Anesthesia (PSI 1) Numerator: Discharges with ICD-9-CM diagnosis codes for anesthesia complications in any secondary diagnosis field. ICD-9-CM Anesthesia Complications diagnosis codes: Adverse effects in therapeutic use, other central nervous system depressants and anesthetics: E8763 ENDOTRACHEAL TUBE WRONGLY PLACE DURING ANESTHETIC PROCEDURE E9381 HALOTHANE E9382 OTHER GASEOUS ANESTHETICS E9383 INTRAVENOUS ANESTHETICS E9384 OTHER AND UNSPECIFIED GENERAL ANESTHETICS E9385 SURFACE AND INFILTRATION ANESTHETICS E9386 PERIPHERAL NERVE AND PLEXUS BLOCKING ANESTHETICS E9387 SPINAL ANESTHETICS E9389 OTHER AND UNSPECIFIED LOCAL ANESTHETICS Poisoning by other central nervous system depressants and anesthetics: 9681 HALOTHANE 9682 OTHER GASEOUS ANESTHETICS 9683 INTRAVENOUS ANESTHETICS 9684 OTHER AND UNSPECIFIED GENERAL ANESTHETICS 9687 SPINAL ANESTHETICS E8551 ACCIDENTAL POISONING, OTHER NERVOUS SYSTEM DEPRESSANTS Denominator: All surgical discharges, 18 years and older or MDC 14 (pregnancy, childbirth, and puerperium), defined by specific DRGs and an ICD-9-CM code for an operating room procedure. See Appendix A: Operating Room Procedure Codes See Appendix B: Surgical Discharge DRGs Exclude cases: with ICD-9-CM diagnosis codes for anesthesia complications (see Numerator) in the principal diagnosis field with codes for self-inflicted injury, poisoning due to anesthetics (E8551, 9681-4, 9687) and any diagnosis code for active drug dependence, or active nondependent abuse of drugs See Appendix L: Self-Inflicted Injury Diagnosis Codes Control-click (Word) or click (PDF) to view the Appendix. Links are provided to return to the PSI Detailed Definition. PSI Technical Specifications 1 Version 3.0a (May 1, 2006) AHRQ Quality Indicators Web Site: http://www.qualityindicators.ahrq.gov Complications of Anesthesia (PSI 1) ICD-9-CM Active Drug Dependence diagnosis codes: 30400 OPIOID TYPE DEPENDENCE - UNSPECIFIED 30401 OPIOID TYPE DEPENDENCE - CONTINUOUS 30402 OPIOID TYPE DEPENDENCE - EPISODIC 30410 BARBITURATE AND SIMILARLY ACTING SEDATIVE OR HYPNOTIC DEPENDENCE - UNSPECIFIED 30411 BARBITURATE AND SIMILARLY ACTING SEDATIVE OR HYPNOTIC DEPENDENCE - CONTINUOUS 30412 BARBITURATE AND SIMILARLY ACTING SEDATIVE OR HYPNOTIC DEPENDENCE - EPISODIC 30420 COCAINE DEPENDENCE - UNSPECIFIED 30421 COCAINE DEPENDENCE - CONTINUOUS 30422 COCAINE DEPENDENCE - EPISODIC 30430 CANNABIS DEPENDENCE - UNSPECIFIED 30431 CANNABIS DEPENDENCE - CONTINUOUS 30432 CANNABIS DEPENDENCE - EPISODIC 30440 AMPHETAMINE AND OTHER PSYCHO STIMULANT DEPENDENCE - UNSPECIFIED 30441 AMPHETAMINE AND OTHER PSYCHO STIMULANT DEPENDENCE - CONTINUOUS 30442 AMPHETAMINE AND OTHER PSYCHO STIMULANT DEPENDENCE - EPISODIC 30450 HALLUCINOGEN DEPENDENCE - UNSPECIFIED 30451 HALLUCINOGEN DEPENDENCE - CONTINUOUS 30452 HALLUCINOGEN DEPENDENCE - EPISODIC 30460 OTHER SPECIFIED DRUG DEPENDENCE - UNSPECIFIED 30461 OTHER SPECIFIED DRUG DEPENDENCE - CONTINUOUS 30462 OTHER SPECIFIED DRUG DEPENDENCE - EPISODIC 30470 COMBINATIONS OF OPIOID TYPE DRUG W/ ANY OTHER - UNSPECIFIED 30471 COMBINATIONS OF OPIOID TYPE DRUG W/ ANY OTHER - CONTINUOUS 30472 COMBINATIONS OF OPIOID TYPE DRUG W/ ANY OTHER - EPISODIC 30480 COMBINATIONS OF DRUG EXCLUDING OPIOID TYPE DRUG - UNSPECIFIED 30481 COMBINATIONS OF DRUG EXCLUDING OPIOID TYPE DRUG - CONTINUOUS 30482 COMBINATIONS OF DRUG EXCLUDING OPIOID TYPE DRUG - EPISODIC 30490 UNSPECIFIED DRUG DEPENDENCE - UNSPECIFIED 30491 UNSPECIFIED DRUG DEPENDENCE - CONTINUOUS 30492 UNSPECIFIED DRUG DEPENDENCE - EPISODIC ICD-9-CM Active Nondependent Abuse of Drugs diagnosis codes: 30520 CANNABIS ABUSE - UNSPECIFIED 30521 CANNABIS ABUSE - CONTINUOUS 30522 CANNABIS ABUSE - EPISODIC 30530 HALLUCINOGEN ABUSE - UNSPECIFIED 30531 HALLUCINOGEN ABUSE - CONTINUOUS 30532 HALLUCINOGEN ABUSE - EPISODIC 30540 BARBITURATE AND SIMILARLY ACTING SEDATIVE OR HYPNOTIC ABUSE - UNSPECIFIED 30541 BARBITURATE AND SIMILARLY ACTING SEDATIVE OR HYPNOTIC ABUSE - CONTINUOUS 30542 BARBITURATE AND

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