AHRQ Quality Indicators™ (AHRQ QI™) ICD-9-CM and ICD-10-CM/PCS Specification Enhanced Version 5.0 Patient Safety Indicators #22 (PSI #22) Iatrogenic Pneumothorax Rate October 2015 Area-Level Indicator Type of Score: Rate Prepared by: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 540 Gaither Road Rockville, MD 20850 www.qualityindicators.ahrq.gov AHRQ QI™ ICD‐9‐CM and ICD‐10‐CM/PCS Specification Enhanced Version 5.0 2 of 286 PSI #22 Iatrogenic Pneumothorax Rate www.qualityindicators.ahrq.gov PSI #22 Iatrogenic Pneumothorax Rate DESCRIPTION Iatrogenic pneumothorax cases per 100,000 population, ages 18 years and older. Excludes obstetric cases and cases with chest trauma, pleural effusion, thoracic surgery, lung or pleural biopsy, diaphragmatic surgery repair, or cardiac procedures. [NOTE: The software provides the rate per population. However, common practice reports the measure as per 100,000 population. The user must multiply the rate obtained from the software by 100,000 to report events per 100,000 population.] October 2015 AHRQ QI™ ICD-9-CM and ICD-10-CM/PCS Specification Enhanced Version 5.0 3 of 286 PSI #22 Iatrogenic Pneumothorax Rate www.qualityindicators.ahrq.gov PSI #22 Iatrogenic Pneumothorax Rate NUMERATOR Surgical and medical discharges, for patients ages 18 years and older, with any-listed ICD-9-CM or ICD-10-CM diagnosis codes for iatrogenic pneumothorax. Surgical and medical discharges are defined by specific DRG or MS-DRG codes. Appendix B – Medical Discharge DRGs Appendix C – Medical Discharge MS-DRGs Appendix D – Surgical Discharge DRGs Appendix E – Surgical Discharge MS-DRGs Iatrogenic pneumothorax diagnosis codes: (IATROID) ICD-9-CM Description ICD-10-CM Description 5121 IATROGENIC PNEUMOTHORAX J95811 Postprocedural pneumothorax October 2015 AHRQ QI™ ICD‐9‐CM and ICD‐10‐CM/PCS Specification Enhanced Version 5.0 4 of 286 PSI #22 Iatrogenic Pneumothorax Rate www.qualityindicators.ahrq.gov PSI #22 Iatrogenic Pneumothorax Rate NUMERATOR EXCLUSIONS Exclude cases: • with any-listed ICD-9-CM or ICD-10-CM diagnosis codes for chest trauma • with any-listed ICD-9-CM or ICD-10-CM diagnosis codes for pleural effusion • with any-listed ICD-9-CM or ICD-10-PCS procedure codes for thoracic surgery • with any-listed ICD-9-CM or ICD-10-PCS procedure codes for lung or pleural biopsy • with any-listed ICD-9-CM or ICD-10-PCS procedure codes for diaphragmatic surgery repair • with any-listed ICD-9-CM or ICD-10-PCS procedure codes for cardiac procedure • MDC 14 (pregnancy, childbirth, and puerperium) • with missing gender (SEX=missing), age (AGE=missing), quarter (DQTR=missing), year (YEAR=missing), principal diagnosis (DX1=missing), or county (PSTCO=missing) Pleural effusion diagnosis codes: (PLEURAD) ICD-9-CM Description ICD-10-CM Description 0101 TUBERCULOUS PLEURISY IN PRIMARY PROGRESSIVE A150 Tuberculosis of lung TUBERCULOSIS 01010 TUBERCULOUS PLEURISY IN PRIMARY PROGRESSIVE A156 Tuberculous pleurisy TUBERCULOSIS, UNSPECIFIED 01011 TPIPPT, BACTERIAL OR HISTOLOGICAL EXAM NOT DONE C782 Secondary malignant neoplasm of pleura 01012 TPIPPT, BACTERIAL OR HISTOLOGICAL EXAM UNKNOWN J90 Pleural effusion, not elsewhere classified 01013 TPIPPT, TUBERCLE BACILI FOUND BY MICROSCOPY J910 Malignant pleural effusion 01014 TPIPPT, TUBERCLE BACILI NOT FOUND BY MICROSCOPY J918 Pleural effusion in other conditions classified elsewhere BUT BY BACTERIAL CULTURE 01015 TPIPPT, TUBERCLE BACILI NOT FOUND BY J940 Chylous effusion BACTERIOLOGICAL BUT CONFIRMED HISTOLOGICALLY October 2015 AHRQ QI™ ICD‐9‐CM and ICD‐10‐CM/PCS Specification Enhanced Version 5.0 5 of 286 PSI #22 Iatrogenic Pneumothorax Rate www.qualityindicators.ahrq.gov 01016 TPIPPT, TUBERCLE BACILI NOT FOUND BY J942 Hemothorax BACTERILOGICAL OR HISTOLOGICAL BUT CONFIRMED OTHER METHODS 0117 TUBRCULOUS PNEUMOTHORAX J948 Other specified pleural conditions 01170 TUBRCULOUS PNEUMOTHORAX, UNSPECIFIED 01171 TPNEU, BACTERIAL OR HISTOLOGICAL EXAM NOT DONE 01172 TPNEU, BACTERIAL OR HISTOLOGICAL EXAM UNKNOWN 01173 TPNEU, TUBERCLE BACILI FOUND BY MICROSCOPY 01174 TPNEU, TUBERCLE BACILI NOT FOUND BY MICROSCOPY BUT BY BACTERIAL CULTURE 01175 TPNEU, TUBERCLE BACILI NOT FOUND BY BACTERIOLOGICAL BUT CONFIRMED HISTOLOGICALLY 01176 TPENU, TUBERCLE BACILI NOT FOUND BY BACTERILOGICAL OR HISTOLOGICAL BUT CONFIRMED OTHER METHODS 0120 TUBERCULOUS PLEURISY 01200 TUBERCULOUS PLEURISY, UNSPECIFIED 01201 TP, BACTERIAL OR HISTOLOGICAL EXAM NOT DONE 01202 TP, BACTERIAL OR HISTOLOGICAL EXAM UNKNOWN 01203 TP, TUBERCLE BACILI FOUND BY MICROSCOPY 01204 TP, TUBERCLE BACILI NOT FOUND BY MICROSCOPY BUT BY BACTERIAL CULTURE 01205 TP, TUBERCLE BACILI NOT FOUND BY BACTERIOLOGICAL BUT CONFIRMED HISTOLOGICALLY 01206 TP, TUBERCLE BACILI NOT FOUND BY BACTERILOGICAL OR HISTOLOGICAL BUT CONFIRMED OTHER METHODS 1972 SECOND MALIG NEO PLEURA 5111 WITH EFUSION, WITH MENTION OF A BACTERIAL CAUSE OTHER THAN TUBERCULOSIS 5118 OTHER SPECIFIED FORM OF EFFUSION, EXCEPT TUBERCULOUS October 2015 AHRQ QI™ ICD‐9‐CM and ICD‐10‐CM/PCS Specification Enhanced Version 5.0 6 of 286 PSI #22 Iatrogenic Pneumothorax Rate www.qualityindicators.ahrq.gov 51181 MALIGNANT PLEURAL EFFUSN 51189 EFFUSION NEC EXC TB 5119 UNSPECIFIED PLEURAL EFFUSION Thoracic surgery procedure codes: (THORAIP) ICD-9-CM Description ICD-10-PCS Description 0522 CERVICAL SYMPATHECTOMY 01520ZZ Destruction of Phrenic Nerve, Open Approach 0523 LUMBAR SYMPATHECTOMY 01523ZZ Destruction of Phrenic Nerve, Percutaneous Approach 0529 OTHER SYMPATHECTOMY 01524ZZ Destruction of Phrenic Nerve, Percutaneous Endoscopic Approach 0780 THYMECTOMY NOS 015K0ZZ Destruction of Head and Neck Sympathetic Nerve, Open Approach 0781 OTH PART EXCISION THYMUS 015K3ZZ Destruction of Head and Neck Sympathetic Nerve, Percutaneous Approach 0782 OTH TOTL EXCISION THYMUS 015K4ZZ Destruction of Head and Neck Sympathetic Nerve, Percutaneous Endoscopic Approach 0783 THORAC PART EXISN THYMUS 015L0ZZ Destruction of Thoracic Sympathetic Nerve, Open Approach 0784 THORAC TOTAL EXC THYMUS 015L3ZZ Destruction of Thoracic Sympathetic Nerve, Percutaneous Approach 3121 MEDIASTINAL TRACHEOSTOMY 015L4ZZ Destruction of Thoracic Sympathetic Nerve, Percutaneous Endoscopic Approach 3145 OPEN BIOPSY OF LARYNX OR TRACHEA 015M0ZZ Destruction of Abdominal Sympathetic Nerve, Open Approach 3173 CLOSURE OF OTHER FISTULA OF TRACHEA 015M3ZZ Destruction of Abdominal Sympathetic Nerve, Percutaneous Approach 3179 OTHER REPAIR AND PLASTIC OPERATIONS ON TRACHEA 015M4ZZ Destruction of Abdominal Sympathetic Nerve, Percutaneous Endoscopic Approach 3199 OTHER OPERATIONS ON TRACHEA 015N0ZZ Destruction of Lumbar Sympathetic Nerve, Open Approach 3209 OTHER LOCAL EXCISION OR DESTRUCTION OF LESION OR 015N3ZZ Destruction of Lumbar Sympathetic Nerve, Percutaneous TISSUE OF BRONCHUS Approach October 2015 AHRQ QI™ ICD‐9‐CM and ICD‐10‐CM/PCS Specification Enhanced Version 5.0 7 of 286 PSI #22 Iatrogenic Pneumothorax Rate www.qualityindicators.ahrq.gov 321 OTHER EXCISION OF BRONCHUS 015N4ZZ Destruction of Lumbar Sympathetic Nerve, Percutaneous Endoscopic Approach 3220 THORAC EXC LUNG LESION 01BK0ZZ Excision of Head and Neck Sympathetic Nerve, Open Approach 3221 PLICATION OF EMPHYSEMATIOUS BLEB 01BK3ZZ Excision of Head and Neck Sympathetic Nerve, Percutaneous Approach 3222 LUNG VOLUME REDUCTION SURGERY 01BK4ZZ Excision of Head and Neck Sympathetic Nerve, Percutaneous Endoscopic Approach 3223 OPEN ABLTN LUNG LES/TISS 01BL0ZZ Excision of Thoracic Sympathetic Nerve, Open Approach 3224 PERC ABLTN LUNG LES/TISS 01BL3ZZ Excision of Thoracic Sympathetic Nerve, Percutaneous Approach 3225 THOR ABLTN LUNG LES/TISS 01BL4ZZ Excision of Thoracic Sympathetic Nerve, Percutaneous Endoscopic Approach 3226 ABLTN LUNG TISS NEC/NOS 01BM0ZZ Excision of Abdominal Sympathetic Nerve, Open Approach 3227 BRNC THRMPLSTY, ABLT MSCL 01BM3ZZ Excision of Abdominal Sympathetic Nerve, Percutaneous Approach 3228 ENDOSCOPIC EXCISION OR DETRUCTION OF LESION OR 01BM4ZZ Excision of Abdominal Sympathetic Nerve, Percutaneous TISSUE OF LUNG Endoscopic Approach 3229 OTHER LOCAL EXCISION OR DESTRUCTION OF LESION OR 01BN0ZZ Excision of Lumbar Sympathetic Nerve, Open Approach TISSUE OF LUNG 323 SEGMENTAL RESECTION OF LUNG 01BN3ZZ Excision of Lumbar Sympathetic Nerve, Percutaneous Approach 3230 THORAC SEG LUNG RESECT 01BN4ZZ Excision of Lumbar Sympathetic Nerve, Percutaneous Endoscopic Approach 3239 OTH SEG LUNG RESECT NOS 01DK0ZZ Extraction of Head and Neck Sympathetic Nerve, Open Approach 324 LOBECTOMY OF LUNG 01DK3ZZ Extraction of Head and Neck Sympathetic Nerve, Percutaneous Approach 3241 THORAC LOBECTOMY LUNG 01DK4ZZ Extraction of Head and Neck Sympathetic Nerve, Percutaneous Endoscopic Approach October 2015 AHRQ QI™ ICD‐9‐CM and ICD‐10‐CM/PCS Specification Enhanced Version 5.0 8 of 286 PSI #22 Iatrogenic Pneumothorax Rate www.qualityindicators.ahrq.gov 3249 LOBECTOMY OF LUNG NEC 01DL0ZZ Extraction of Thoracic Sympathetic Nerve, Open Approach 325 COMPLETE PNEUMONECTOMY 01DL3ZZ Extraction of Thoracic Sympathetic Nerve, Percutaneous Approach 3250 THORACOSPC PNEUMONECTOMY 01DL4ZZ Extraction of Thoracic Sympathetic Nerve, Percutaneous Endoscopic Approach 3259 OTHER PNEUMONECTOMY NOS 01DM0ZZ Extraction of Abdominal Sympathetic Nerve, Open Approach 326 RADICAL DISSECTION OF THORACIC STRUCTURES 01DM3ZZ Extraction of Abdominal Sympathetic Nerve, Percutaneous Approach 329 OTHER EXCISION OF LUNG 01DM4ZZ Extraction of Abdominal Sympathetic Nerve, Percutaneous Endoscopic Approach 330 INCISION OF BRONCHUS 01DN0ZZ Extraction of Lumbar Sympathetic Nerve, Open Approach 331 INCISION