Not to sound like a Mastercard commercial but I cannot thank you all enough for taking the time to provide your practice, thoughts, and expertise. Having this list-serv to be able to ask questions from experts of your caliber is truly “Priceless”!!! I will definitely be watching for the task forces presentation from Phoenix!
Thank you again so very, very much! Claudia Claudia Orth BSN, RN, CCRN-K Regional Sepsis Coordinator Munson Medical Center (231) 935-5692 (Voice) [email protected]<mailto:[email protected]> From: William Haik [mailto:[email protected]] Sent: Sunday, January 18, 2015 8:35 PM To: Malik,Imrana Cc: Orth, Claudia; [email protected] Subject: Re: [Sepsis Groups] SIRS/Sepsis Criteria and Coding There is no literature that I am aware of that parses the sirs criteria however what you say does make sense and is what I actually do in defining sepsis William E. Haik, M.D., F.C.C.P., C.D.I.P. AHIMA Approved ICD-10-CM/PCS Trainer Office: (850) 863-2110<tel:(850)%20863-2110> Cell: (850) 803-5854<tel:(850)%20803-5854> Fax: (850) 864-4438<tel:(850)%20864-4438> On Jan 17, 2015, at 12:50 PM, Malik,Imrana <[email protected]<mailto:[email protected]>> wrote: SIRS criteria is only met if 2 out of the 4 are positive, of which one MUST be a derangement in Temp or WBC. So tachycardia with tachypnea alone should not be considered positive. Hope that helps. ________________________________ From: Sepsisgroups [[email protected]<mailto:[email protected]>] on behalf of Orth, Claudia [[email protected]<mailto:[email protected]>] Sent: Tuesday, January 13, 2015 2:00 PM To: [email protected]<mailto:[email protected]> Subject: [Sepsis Groups] SIRS/Sepsis Criteria and Coding I am writing to inquire how other institutions are handling or if you are even encountering concerns, that we are “over-calling” early sepsis, especially when the only SIRS criteria are tachycardia and tachypnea (sometimes only a single set of VS). We are reviewing all short stay (Observation, 1-2 day stays) and see “septic” patients who are “in no acute distress”, are only here in Observation status and never Inpatient, or stay as IP only 1-2 days, are not sent home on any antibiotics or only a short course of oral antibiotics. Often their only SIRS criteria are tachycardia and tachypnea—which are quite non-specific markers that can be seen with anxiety, pain, etc. but when paired with a suspected or documented infection role up to Sepsis?! Since Sepsis is a high-paying condition it’s also a high audit DRG (mainly because, in the past, many patients were in ICU, very ill, and expending lots of resources). Now that “early sepsis” is being diagnosed quite frequently, external auditors are reviewing sepsis DRG charts, and disagree that sepsis was present at all, recode the chart, reassign the DRG and reduce payment to UTI, pneumonia, etc. This is so frustrating as we are trying to educated our providers and nurses on the importance of having a high suspicion for sepsis and early recognition and now are turning around and saying don’t say ‘Sepsis’ unless they are “sick” because we need to be able to defend it!? ☹ Any feedback, thoughts, or tools on how other institutions are handling this, would be greatly appreciated especially when it comes to the SIRS criteria which most of our clinicians call “soft criteria”? Thank you in advance for your time and expertise! Claudia Claudia Orth BSN, RN, CCRN-K Regional Sepsis Coordinator Munson Medical Center (231) 935-5692 (Voice) [email protected]<mailto:[email protected]> _______________________________________________ Sepsisgroups mailing list [email protected]<mailto:[email protected]> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
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