Specifications Manual 5.7 states:
Choose Value “2” if within 6 hours after documentation meeting clinical
criteria or physician/APN/PA documentation of Severe Sepsis there is additional
physician/APN/PA documentation indicating: ….
o Severe Sepsis or Septic Shock is due to a viral, fungal, or
Amy is correct about SEP-1 spec manual directing abstractors to use
documentation of viral infections to exclude that in the time of presentation
criteria as suspicion of infection. We are dealing with this issue and
providers looking for a “workaround” to avoid a SEP-1 failure in our COVID19
Here is the question that we submitted and the response that we received from
CMS:
If Covid-19 or Covid-19 suspect are in the final discharge diagnosis, do
patients excluded from the Sep-1 bundle (since it is a viral infection)?
Thank you for your question.
You would disregard documentation
